Oral Answers to Questions

WORK AND PENSIONS

The Secretary of State was asked—

Poverty

Celia Barlow: What steps he proposes to take to work with the voluntary sector to tackle poverty.

James Purnell: The Government see a vital role for the voluntary sector in tackling poverty. In 2006, more than a quarter of new deal main contracts were awarded to voluntary sector organisations and more than a third of subcontractors are from the sector. Next week, the Department will publish its commissioning strategy. Throughout the consultation on the strategy, we have made it clear that the voluntary sector will play a growing role.

Celia Barlow: Volunteering provides a much-needed road into employment for many of the long-term unemployed. Brighton and Hove volunteer centre in my constituency has worked with more than 400 voluntary organisations this year, providing the unemployed with much-needed skills, necessary references and some confidence. What does my right hon. Friend hope to do to help provide that service?

James Purnell: I wish to start by paying tribute to my predecessor and the radical programme of welfare reform that he established. I am honoured to be building on the work that he achieved.
	I congratulate the centre that my hon. Friend mentioned and reassure her that volunteering and the voluntary sector are at the heart of our programmes to get people back into work. Volunteering can teach people important skills that bring them closer to the labour market, and the voluntary sector plays a growing role in getting people who are on incapacity benefit and those in the new deal back into work.

Chris Grayling: I welcome the Secretary of State to his position and look forward to debating with him in the months ahead. I also welcome the Minister for Employment and Welfare Reform to his new Front-Bench job. He and I have had debates in the past and it is a pleasure to see him there.
	Are the Government on track for achieving their target of halving child poverty by 2010?

James Purnell: The Government are committed to the goal of reducing child poverty. We continue to keep the strategy under review and we will make announcements at the appropriate time. However, it is surprising that the hon. Gentleman raises the issue when I do not believe that the Conservative party is committed to even an aspiration, let alone a pledge, to reduce child poverty. Perhaps he would like to answer that point.

Chris Grayling: I look forward to our changing jobs in the near future. From the lack of an answer to my question, I judge that the Government will not achieve their target of halving child poverty by 2010. Will the Secretary of State give the House a sense of when the Government hope to achieve that target?

James Purnell: As I said, the Government are committed to the target. The House will notice that the hon. Gentleman ducked the question on whether the Conservative party is committed to the goal. Under his predecessor, it was at least an aspiration, but it is not even that now. He is not prepared to say that he shares the aspiration of getting children out of poverty in this country, which is shameful.

Child Support Agency

Robert Flello: What assessment he has made of the performance of the Child Support Agency following the introduction of the operational improvement plan.

James Plaskitt: The agency's performance has improved significantly since the operational improvement plan was launched in April 2006.
	In simple terms, thanks to the plan, so far, 80,000 more children are being supported by an extra £140 million of payments. The number of uncleared cases is falling steadily and processing times are speeding up.

Robert Flello: Several of my constituents are on the old CSA system and fear that they are consequently worse off. What advice can my hon. Friend give my constituents? In what time frame can they expect to be moved off the old system?

James Plaskitt: We all have a sense of frustration about the timing, and about the difficulties that the existence of two schemes running side by side creates. However, as we have always said, transfer from one to the other could not be undertaken safely or have any chance of being completed until the IT system was up to scratch. That is where the big problem lies. My hon. Friend knows that, as part of the operational improvement programme, major investment is now being made in IT and that there will be a major re-engineering at Easter. From next year, as we move to the new commission arrangement, parents will be able to choose whether to have a private arrangement, stick with an existing scheme that works or move into the new system. After that, we can migrate everyone to one unified system.

Geoffrey Clifton-Brown: The Under-Secretary may know that I held an Adjournment debate as long ago as 24 July last year on the CSA constituency case of Mrs. Sonia Poulton. I do not know how he can stand at the Dispatch Box and say that the agency's performance is getting better. I have corresponded with him since the Adjournment debate, to which the Under-Secretary of State for Work and Pensions, the hon. Member for Stirling (Mrs. McGuire) replied. I tabled a pursuant question for answer on 17 January, and it has not been answered—

Mr. Speaker: Order. Another Adjournment debate might be in order.

James Plaskitt: I said that the CSA was performing better; I did not say that it had reached a state of perfection. I hope that the hon. Gentleman will acknowledge that the fact that 80,000 more children are being supported, that £140 million more is being collected in maintenance, that the number of uncleared cases is down by 45 per cent. since the plan started and that the agency is now clearing 50 per cent. of cases within six weeks is all improvement. I fully accept that there are still problems with some cases, and I will look into the constituency case that he raises. I will consult colleagues who have dealt with the correspondence and come back to him.

Linda Gilroy: I welcome the improvements in the operational improvement plan that my hon. Friend outlined. He mentioned the computer upgrade, which is due at Easter and upon which a great deal depends. Will he meet me to discuss how staff such as those at the Plymouth office can be encouraged in the work that they are doing, despite the uncertainty that the future holds for them, so that he can continue to make such announcements at the Dispatch Box in future?

James Plaskitt: My hon. Friend will know that I have visited the Plymouth office, where I discussed with the staff both the agency's current performance and the move to the new commission arrangement. I am pleased to report that the staff are behind the work that the Department is doing and fully support the move to the commission. In so far as they have any reservations about their status, which they raised when I visited, we have been able to resolve them by telling the staff that they will remain Crown employees. The staff fully support the changes that we are making, because they want to be part of a child maintenance arrangement that works.

Andrew Selous: The abolition of pension contribution limits means that children are suffering, as huge pension contributions are now allowable deductions from income assessed for child support. A mother from your hometown, Mr. Speaker, has called this "a loophole that can be exploited by parents lining their own pockets, rather than paying for their responsibilities." Her MP, the hon. Member for East Renfrewshire (Mr. Murphy), has called this clearly unfair. Does the Minister agree, and will he ensure that the law is changed?

James Plaskitt: As I have already pointed out, despite such issues, the agency is collecting £140 million more in child support than it was before, on behalf of 80,000 more children. The hon. Gentleman knows that when the commission takes over later this year, there will be an opportunity to review other aspects of the agency's arrangements—he and I have debated the issue in Committee, and he knows that to be the case. The important thing is to ensure that we build a platform of success within the existing agency for when the commission takes over. It will then have the opportunity to review all the arrangements covering the current maintenance systems.

Frank Field: I congratulate the Minister on the improvements he has announced today. Will he indicate—if not now, in a note in the Library—how many children have to wait six months and how many have to wait more than 12 months before the first of their often irregular maintenance payments arrives?

James Plaskitt: I can certainly supply my right hon. Friend with that information. He is right that there are unacceptable waits in some cases—after all, 38 per cent. of non-resident parents are failing to pay part or all of their maintenance assessment. That is clearly not acceptable, but we are dealing with people who will sometimes go to the most extraordinary lengths to avoid facing up to their clear responsibility, and the agency cannot always do all that it would like in going after them. However, in addition to the improvements to which I have referred, the agency is now taking a record level of enforcement action to go after the non-resident parents who will not pay, with record numbers of charging orders, suspended committal sentences, removals of driving licences and deduction from earnings orders, as well as doing more than ever before to collect arrears.

Poverty

Greg Hands: What recent assessment he has made of poverty rates among disadvantaged groups.

James Purnell: We have made considerable progress in tackling poverty. Since 1998-99, the number of pensioners in relative poverty has fallen by more than 1 million, and the number of individuals in relative poverty living in households continuing a disabled person, after housing costs, has fallen by about 900,000. There are now 600,000 fewer children living in relative poverty, before housing costs, than there were in 1998-99.

Greg Hands: The UK has a higher proportion of children living in workless households than any other EU country and, according to the Sutton Trust, social mobility in the UK is at the lowest level of any developed country. What connection does the Minister make between those two facts?

James Purnell: I make the connection that, for 18 years, there was a huge rise in child poverty— [ Interruption. ] That is a serious point. We cannot measure the life chances of a child who is 10 years old, which is the oldest that they could be if they had spent the whole of their life growing up under this Government. Those figures clearly measure life chances over the past two or three decades. We inherited a significant problem of child poverty; we have cut it by 600,000, and we have measures in place to cut it by another 300,000. The proportion of children in workless households has fallen by 400,000 under this Government. It was rising under the Tories, which damaged children's life chances, but it is now falling under us. Over the next 20 years, as we are able to judge those children's life chances, I believe that we will see a significant improvement.

Tony Lloyd: Will my right hon. Friend confirm that, when dealing with families living at the bottom end of the economic ladder and those with young children, there can be no scope for using the removal of housing as part of the process of getting people back into the world of work? Will he confirm that there are better ways of doing that, and that it would be unworkable and unacceptable to use housing as a weapon in that way?

James Purnell: I think that my hon. Friend is referring to the debate that the Minister for Housing has started about people's responsibilities in respect of social housing. It is right that, when people get social housing, which is much sought after, we should talk about the responsibilities that go with that. That is exactly the debate that my right hon. Friend has started. One thing that could be done, for example, is to ensure that applicants for social housing get employment support alongside it. We could take other measures as well. That is a debate that my right hon. Friend the Minister and I will be happy to have with my hon. Friend in the coming weeks.

Tony Baldry: The Department's own statistics on households on below-average incomes show that, since 2001, the bottom 10 per cent. of families have become worse off. They are going backwards, and getting poorer. How has that come about?

James Purnell: The figures on the proportion of people who are on below 40 per cent. of median earnings—I think that is what the hon. Gentleman was referring to—have been described by the Office for National Statistics as not reliable. For example, there are many people in that category who do not declare any income at all. There may well be a certain amount of fraud in those figures, and the sample size is too small anyhow. The figures that are internationally recognised, which relate to those on less than 60 per cent. of median earnings, have shown a fall of 600,000 since 1997, and we have measures in place for another 300,000 to be taken out of poverty. The clearest contrast, however, is the one between this Government, who are committed to reducing child poverty, and the Opposition, who will not even say that they have an aspiration to reduce it.

David Taylor: I see from the Annunciator that, following these questions, the Chancellor is to make a statement that will help us to deliver on our 1983 manifesto pledge on banking. Will the Secretary of State tell us whether it will be 25 years before we deliver on our 2005 manifesto commitment to a full programme of action to support disabled people in leading independent lives and to increase their inclusion in the economy and in society? The Independent Living Fund has just announced that it is raising from £200 to £320 the threshold sum that a disabled person must be receiving from local authorities in order to access ILF funding. Will not this worsen poverty and increase disabled people's exclusion from society?

James Purnell: I believe that that was done in consultation with local authorities and will not affect existing claimants. We do not think that a significant number of people will be affected. My hon. Friend is right, however, to say that the Government have a radical goal of getting equality for disabled people by 2025, and we have a number of policies in place to achieve that. However, I would be happy to talk to him if he has any further suggestions on what course the Government should be pursuing.

Mark Harper: The recent report by Leonard Cheshire Disability shows that disabled people are twice as likely to live in poverty as non-disabled people; I know that the Secretary of State will be familiar with that. Over the past 10 years, the employment rate of people with work-limiting disabilities has risen by just 3.7 per cent., according to the Government's own figures. What specific policies do the Government have to enable them to do better in future, and why should anyone think that they are any more likely to be successful?

James Purnell: I look forward to meeting Leonard Cheshire Disability and I am happy to look into the suggestions it has made. As the hon. Gentleman says, there has been an improvement in the employment rate of disabled people, but we want to go further. Reforming incapacity benefit by introducing the employment and support allowance will, we believe, help to get about 1 million people off incapacity benefit and into work. At the end of the spectrum where people have really significant barriers to work, we should be clear that we are not saying that they cannot work—we want to support everyone who wants to work—but we are seeing what more control we can give people in that situation so that disabled people, like everybody else, can have the expectation of being able to get into work.

Pensions

Henry Bellingham: If he will meet pensioner groups from East Anglia to discuss payment of old age pensions and related benefits.

Mike O'Brien: I regularly meet national pensioners' organisations, which seek to reflect the views of pensioners from East Anglia and other parts of the country. I hope to visit Norwich in the next few months and I intend to meet a pensioners' group there.

Henry Bellingham: I thank the hon. and learned Gentleman for that reply, but is he aware that the number of pensioners living in households earning less than 40 per cent. of the national average income is rising to a figure of nearly 500,000? Is he aware, more particularly, that pensioners in East Anglia have been hit especially hard by council tax increases—so much so that many pensioner households are now spending a very large percentage of their income on council tax bills? What plans does the Minister have to help those pensioners who just miss out on council tax rebate to get some respite?

Mike O'Brien: I would hesitate, if I were a Conservative, to complain about pensions, given that under the Conservative Government the poorest pensioners were forced to exist on only £69 a week—barely enough, one would have thought, to pay for a bottle at the Bullingdon club. We have done an awful lot to help pensioners, and the number of pensioners living in relative poverty has fallen by more than 1 million since 1997. Just before Christmas, I announced some new proposals to help large numbers of pensioners who are not claiming pension credit or, indeed, the help that they need with council tax at the moment. When these proposals come into effect next year, we will mount a campaign to encourage pensioners to apply for help with council tax, which will automatically bring them some of the other benefits to assist them more widely. Pensioners' organisations asked for that, and they have broadly welcomed it.

Andrew MacKinlay: Will the Minister look again into the disadvantage suffered by people who reach retirement age, but are in receipt of a carer's allowance and are caring for their loved ones? By what logic are they penalised or disadvantaged, particularly bearing in mind the fact that some devolved Assemblies in the UK are about to consider unilaterally remedying that wrong?

Mike O'Brien: I looked into this problem recently, as some carers raised it with me. The benefits system does not allow for double payments. We are looking into ways of helping pensioners better to deal with some of the problems that they face. There are anomalies whereby someone living in an area receives help while the person living next door does not—and these are a matter of concern to us. I do not have an easy answer for my hon. Friend now, but I recognise the nature of the problem. It is an expensive problem to resolve, but we are still looking into ways of doing so.

Child Poverty

Alistair Carmichael: Whether his Department plans to simplify the welfare system with a view to reducing child poverty as recommended by the Scottish Affairs Committee in its report, "Child Poverty in Scotland".

Stephen Timms: The reduction in poverty has been greater in Scotland than elsewhere, but there is undoubtedly more to do. I welcome the Scottish Affairs Committee report and we will respond to it fully in due course. We need a simpler benefits system to make it easier for people to make claims and understand their responsibilities.

Alistair Carmichael: The Minister will be aware that one of the ideas canvassed by the Scottish Affairs Committee, for which some enthusiasm was expressed by those giving evidence, was the equalisation of child benefit rates. What consideration is the Department giving to that idea, and when can we expect it to share its thinking with us?

Stephen Timms: All I can say at this stage is that we will respond in full to the proposals in the report, which I welcome, as I welcome the hon. Gentleman's contribution to it. We are taking a number of steps to simplify the benefits system, including the introduction of the employment and support allowance, to which my right hon. Friend the Secretary of State referred earlier. We want a system that makes it clearer to people what they are entitled to and how they can access it. As I say, we will respond to the detailed proposals in the report in due course.

Jim Devine: As a member of the Committee, may I say that one of the most concerning aspects that we came across was that disabled children are four times as likely to be in poverty as non-disabled children? Does my right hon. Friend share my concern that of the £34 million allocated by the Government and specifically targeted on that disadvantaged group, not one penny has reached a health board, a local authority or a social work department? Will he join me in condemning the Scottish Government for their behaviour?

Stephen Timms: I am very happy to condemn the Scottish Government. My hon. Friend raises an important point. He knows that the children and young people's review, conducted as part of the comprehensive spending review, has a major focus on the needs of disabled children and improving their life chances. I welcome his contribution.

Julie Kirkbride: Will the Minister answer the question posed by my hon. Friend the Member for Epsom and Ewell (Chris Grayling) but ducked by the Secretary of State on what year the Government intend to reach their target of halving child poverty in Scotland and elsewhere in the United Kingdom?

Stephen Timms: I understand that the target has been reached in Scotland. As my right hon. Friend the Secretary of State said, we remain committed to making further progress and to the abolition of child poverty entirely by 2020. We have made good progress. The number of children growing up in poverty has fallen by 600,000 since 1997, it having doubled under the policies of the Conservatives.

Worklessness

David Gauke: What assessment he has made of trends in the level of worklessness among under 25-year-olds since 1997.

John Penrose: What assessment he has made of trends in the level of worklessness among under 25-year-olds since 1997.

Stephen Timms: The level of 16 to 24-year-olds not in work or full-time education has fallen from 17.8 per cent. in 1997 to 16.9 per cent. today.

David Gauke: I welcome the Minister to his new position. Given the high figure of people aged 16 to 24 who are out of work, and in particular given that the number of people in that age group who are economically inactive and not in full-time education has increased by 144,000 since 1997, does he still maintain the position that the current Prime Minister advocated in 2005, that youth unemployment has been virtually abolished?

Stephen Timms: I thank the hon. Gentleman for his kind welcome. Let me make two points. First, it is true that the population of young people has increased, but the percentage—the proportion—not in education, employment or training has fallen, as I said to him. Secondly, it is also the case—this is the important point—that many fewer young people today are unemployed for long periods, and the periods in which they are out of education, employment or training tend to be short.
	To pick up on the point about my right hon. Friend the Prime Minister, in May 1997, more than 85,000 18 to 24-year-olds had been claiming jobseeker's allowance for more than 12 months. That fell last month and it is now fewer than 7,000. My right hon. Friend was absolutely right.

John Penrose: May I pick the Minister up on his point about the duration of employment of young people? Does he agree that it is scandalous that the proportion of people who have been through the Government's new deal for young people and still have a job within one year of leaving is less than one half of those people who get a job in the first place? In other words, one out of two lose their job within the first year. Does he agree that that figure urgently needs to be improved?

Stephen Timms: I can tell the hon. Gentleman that 750,000 young people have gone into work through the new deal; much of that has been sustained work. That is the reason for the dramatic improvement in unemployment across the economy. He may well have seen the employment figures published last week, which show that more people in the UK are in work than ever before—almost 29.4 million—and that for the first time since June 1975 the number of people claiming unemployment benefits has fallen below 800,000. That is dramatic progress. The new deal for young people is an important part of the explanation for that. Of course we need to go further, and we will do, but employment opportunities today are unprecedented for young people and others. We are determined to make the most of them.

Andrew Miller: Will my right hon. Friend look at the progress made in the Cheshire Oaks retail area in my constituency, where he will see a partnership between the FE college, local authorities, the DWP and employers, who together have set up a retail training centre, which has had a profound impact on the life chances of people from some of the most disadvantaged parts of the constituency? Will he discuss that with his opposite numbers in the Department with responsibility for employment and see whether the model can be applied elsewhere?

Stephen Timms: My hon. Friend is absolutely right. Very good progress is being made as a result of the partnership arrangements that he describes. He gave a good constituency example of local employment partnerships. Last Thursday I was at the Nissan plant in Sunderland, signing a local employment partnership with the company. We have said that through Jobcentre Plus and its partners we will ensure that people have the skills and abilities to secure the jobs that are available, the other side of the deal being that employers will give disadvantaged unemployed people a fair crack at those jobs. I am confident that we will continue to make substantial progress in reducing the number of people who have been out of work for some time.

David Kidney: This September, the new 14-to-19 curriculum and the first of the new diplomas will begin. The number of apprenticeship places is expected to continue to rise, from the current 240,000 to the eventual target of 400,000 a year, and in due course we will make it compulsory for 16 and 17-year-olds to remain in education and training. How will Jobcentre Plus be involved in those developments? May I suggest that it can play an important role in continuing to engage employers in providing for the necessary expansion in skills training opportunities?

Stephen Timms: Jobcentre Plus will continue to play a central role in brokering partnerships and the other arrangements that my hon. Friend has described. It is true that we must address skills increasingly in the welfare system.
	My hon. Friend was also right to draw attention to the growing number of apprenticeships, which almost disappeared altogether under the last Government. Now, 100,000 apprenticeships are being completed each year, and we have the longer-term objective outlined by my hon. Friend. In future, people taking up the flexible new deal will go to Jobcentre Plus, where they will be helped by advisers; specialist tailored help will then be given by others who are contracted through Jobcentre Plus, which will thus have a central role, while working with a wide array of partners.

Ann Winterton: Is it not a fact that 1.25 million people between the ages of 16 and 24 are neither in work nor in full-time education, more than when the Government came to office? Is it not also true that half a million young people up to the age of 35—I consider them still to be young—are not in employment at all? Have not the millions of pounds spent by the Government on various schemes missed their target?

Stephen Timms: Certainly not. Let me repeat what I told the hon. Member for Weston-super-Mare (John Penrose). The proportion of young people not in education, employment or training is down, not up, and many fewer young people are unemployed for long periods. I also refer the hon. Lady to the employment figures published last week. They showed a rise in the employment rate and a fall in the unemployment rate, a fall in the claimant count in every English region—and in Wales and Scotland—a rise in the number of vacancies, and the fewest redundancies across the economy in the last quarter of last year since records began in 1995. Those are the results of the new stability achieved in the United Kingdom's economy over the past 10 years, and of our active labour market policies.

James Clappison: I join others in welcoming the Minister to his new post. May I gently suggest that he avoid some of the woes that his predecessors have experienced in trying to suggest that the huge increase in the number of foreign workers is some sort of answer to the deep-seated problem of youth unemployment? Should he not face the fact that the new deal has too often acted as a revolving door taking young people from one period on benefits to another, which is reflected in the statistic that youth unemployment is 13 per cent. higher than it was when the Government took office? Is there not also a connection between that and the 400,000 increase in the number of young people living in poverty since 1997, which means that nearly a third of them are in that position? Is it not time that the Government faced up to those problems, and we saw some fresh thinking?

Stephen Timms: I am grateful to the hon. Gentleman for his welcome, but he needs to look at the figures a little more closely. It is a shame that Opposition Members were not worrying about this group of young people when the Government they supported were doubling the rate of child poverty between 1979 and 1997. He appears in the figures he has cited to have included full-time students, who are certainly in no sense part of a lost generation; they are being prepared for the opportunities ahead. Unemployment is down, the claimant count is down, and the number of young people claiming jobseeker's allowance for more than 12 months has fallen from 85,000 in May 1997 to fewer than 7,000 today. We will continue to make sure that the substantial number of opportunities being created in the economy are available, including to people who have been out of work for a long time.

Sunbeds

Si�n James: If he will hold discussions with the Health and Safety Executive on the regulation of sunbeds.

Anne McGuire: The Government's cancer reform strategy commits the Department of Health to review options for controlling health risks through regulation of the sunbed industry, in consultation with relevant stakeholders, including the HSE.

Si�n James: I thank my hon. Friend for her answer, but I ask her to make representations to the HSE on the leaflet IND(G)209. I am particularly concerned about the leaflet, as it has not been updated since 1995 and it needs to include important information for young people on sunbed use. Please will she ensure that?

Anne McGuire: I thank my hon. Friend for her question, which is important as malignant melanoma of the skin is among the five most common cancers in the 15 to 24 age range, and it is estimated that skin cancer rates will treble over the next 20 to 30 years. I can give my hon. Friend the assurance that the HSE is shortly to put out for consultation a revision of its guidance on sunbeds, and that the guidance advises that all tanning salons should be staffed and calls up World Health Organisation guidelines that people under 18 years of age should avoid sunbed use.

Affordable Credit

Russell Brown: What steps he is taking to improve the access of benefit recipients to affordable credit; and if he will make a statement.

James Plaskitt: Access to affordable credit is vital to help tackle vulnerability and reduce poverty. Total Government investment in the growth fund has now reached 80 million, and that is helping to fund tens of thousands of affordable loans to people in receipt of benefit.

Russell Brown: I thank my hon. Friend for that response, but many benefit recipients remain exposed to the activities of some loan companies that conduct their business along the lines of sub-prime lending. Does he agree that there is much to be gained by his Department co-operating with colleagues at the Department for Business, Enterprise and Regulatory Reform in the promotion of easy-to-access credit unions?

James Plaskitt: Yes, I agree with my hon. Friend, and he is absolutely right to point out that many people are victims of the doorstep loan sharks, who sometimes apply interest rates in excess of 1,000 per cent. without, of course, declaring that. We want to protect people from having recourse to such unaffordable credit, and the investment we are making through the growth fund is leading to a substantial expansion of the credit union movement. My hon. Friend is right that we are working with colleagues in the Department for Business, Enterprise and Regulatory Reform, which is funding hundreds of advisers who are working in local areas giving free, face-to-face advice to people on managing their debt.

Bill Olner: Will my hon. Friend redouble his efforts and get in contact with credit unions, which up and down the country do tremendous work in ensuring that good credit is available to low-income families? My own union in Nuneaton is doing very well, but I have to say that if we put as much effort into this area as we have done into saving Northern Rock, we would help an awful lot more people at the poor end of the stick.

James Plaskitt: The credit union in Nuneaton is one of the credit unions that is receiving additional support through the growth fund investment that we are making. That investment is helping to increase substantially the scope of this country's credit union movement. I know that in some areas where growth fund money is being invested the number of people joining local credit unions has doubled, and we hope to see much more of that as we go forward with the next two or three years of growth fund investment. We are finally putting resources behind expanding an important sector that is working in all of our communities and assisting people on low incomes.

Lone Mothers (Work Assistance)

Eric Joyce: What recent steps he has taken to help lone mothers into work.

Stephen Timms: There has been a welcome and large rise in lone-parent employment in the past 10 years. From October, lone parents with older children will be required to seek employment. From April, the in-work credit will be available nationally, and we will pilot a new credit to ensure that lone parents are at least 25 a week better off in work.

Eric Joyce: I thank my right hon. Friend for that answer. Recently, I visited the solve-it programme at Falkirk football club with my right hon. Friend the Member for Kilmarnock and Loudoun (Des Browne). It has an objective of getting 65 per cent. of single mothers who attend back into work, and it has recently been hitting that objective successfully. Will my right hon. Friend the Minister join me in commending the solve-it programme and all those involved in it? Does he agree that it is a great example of how a football club can truly serve its local community?

Stephen Timms: I am pleased to share my hon. Friend's commendation of that initiative. We are also ensuring that lone parents are better off financially in work, because work is good for people's health, their children and the self-esteem of their children. Everybody benefits when lone parents can get back into work, and I welcome the work in my hon. Friend's area.

Anne McIntosh: Everybody would wish to support genuine lone mothers back into work when that is appropriate. However, does the Minister not appreciate that the current tax and benefits system discriminates against married couples? Will he look into that at the earliest possible opportunity?

Stephen Timms: The hon. Lady is absolutely right that everybody is better off when parents are in work. We have made the changes that I have referred to for lone parents, but the point also applies to couples. It is in everybody's interests for people to be in work. Where there is a question whether people are better off in work, Jobcentre Plus advisers can make a calculation to show the financial gains of work, and the better off in work credit will help further. I think that we can agree across the House that it is in everybody's interests for parents to be able to work.

Kerry McCarthy: My understanding is that, under the new deal for lone parents, when lone parents attend jobcentres for interviews their child care and travel costs are met, whereas when they move to the new jobseeker's allowance regime they have to meet those costs from their benefits, which could act as a bit of a disincentive and perhaps lead to sanctions. Will the Minister undertake to look into that, to ensure that lone parents who move from the new deal to the JSA regime are not disadvantaged in such a way?

Stephen Timms: I will certainly examine that point. We want to ensure that lone parents plan for a better future for themselves and their children, and that will require lone parents moving on to more appropriate benefits when their youngest child is 12 and over from October this year, as she knows, and 10 and over and seven and over later. I shall certainly examine her point and drop her a line in response.

Fuel Poverty

Paul Flynn: What plans his Department has to provide further assistance to people experiencing fuel poverty.

Mike O'Brien: We expect to pay 12 million winter fuel payments this winter. In addition, the Pension Service is currently working with energy suppliers to target further help to 250,000 vulnerable pensioners in receipt of pension credit throughout England, Scotland, and Wales. We are also working closely with other Departments to develop a cross-governmental strategy to help further reduce fuel poverty.

Paul Flynn: Will the allowances for fuel increase in line with the cost of fuel this coming year?

Mike O'Brien: That is a decision that the Chancellor will no doubt announce in due course. It is not for me.

Mr. Speaker: I call Anne Moffat; I call Anne Snelgrove. Is Sally Keeble here? Nowhat I can do is to move on to Topical questions.

Topical Questions

Michael Penning: rose[Interruption.]

Mr. Speaker: Order. It is not the hon. Gentleman's fault that others cannot be here.

Michael Penning: If he will make a statement on his departmental responsibilities.

James Purnell: Last November the Government announced a strategy for reducing the number of young people who are not in education, employment or training. As part of those proposals, from next April all young people who have not been in employment, education or training for at least 26 weeks by the time of their 18th birthday will be fast-tracked to the intensive support and sanctions regime of the new deal. If they fail to find work after six months, they will be referred to a specialist provider from the voluntary or private sector.
	I can announce today that we will look to contract with providers who will work with young people in this category to do substantial amounts of work-related activity, underpinned by a minimum of four weeks' full-time work-related activity relevant to the individual. That is an important new initiative to connect young people to the world of work and ensure that they learn basic skills such as teamwork and work-related disciplines, including timekeeping.

Michael Penning: May I say that that was absolutely fascinating? However, two years on from the Buncefield, explosions the inquiry is still going on behind closed doors. Although I criticise its being done behind closed doors, I have no criticism of Lord Newton and his team. Could the Secretary of State assist the inquiry team in reaching a conclusion on whether a criminal prosecution should take place and whether compensation can be paid to my constituents who have suffered so much?

James Purnell: I hope that the hon. Gentleman is interested in my more general announcement, as many Conservative Members have raised the issue of people not in employment, education or training.
	I know that the hon. Gentleman has been campaigning vigorously on the issue that he raises. I will ask the Health and Safety Executive for an update on progress and I would be happy to meet him to discuss his concerns. Clearly, everyone wants to bring the matter to a conclusion as rapidly as possible.

Danny Alexander: I congratulate the Secretary of State on his deserved promotion, but since he took office pronouncements on welfare reform have sent mixed messages: on the one hand, they have threatened to take people's houses, and on the other, they have promoted the idea of financial incentives. When will he face up to the real barriers put up to benefit claimants by the huge complexity of the benefit system, which he has not so far addressed? Will he start by introducing plans for a single working-age benefit, which would do a lot to reduce barriers to work for many benefit claimants?

James Purnell: As the hon. Gentleman knows, I am happy to consider the issue that he raises. It has been considered by many Secretaries of State and the question is always how one moves to such a system without creating a large number of losers, which would it make very difficult to introduce, and compensating all those losers, which would make it very expensive. A single working-age benefit system is desirable in theory, but whether it could be achieved cheaply in practice is a very different question.

Jim Devine: This week I am meeting the office bearers of the Livingston and Blackburn credit union, who are a formidable group. At present, only individuals can join credit unions, but the officers want to know whether groups, such as mother-toddler groups, can be allowed to join. Has my right hon. Friend given any thought to that idea?

James Purnell: I am happy to raise that point with colleagues in the Treasury and the Department for Business, Enterprise and Regulatory Reform. As my hon. Friend knows, we are increasing significantly the support that we give to credit unions to address financial exclusion. There is also a significant role for the social fund, and we will bring forward proposals shortly.

Gerald Howarth: How much is being spent on benefits for migrant workers and their families, especially those from eastern Europe? Is he aware that there is growing concern about what many people believe to be an abuse? What is he going to do about it?

James Purnell: If the hon. Gentleman knows of a specific abuse, he should raise it and I would be happy to look at it. A key part of being in the European Union is that, just as when people from this country retire to Spain they have access to social services there, when people from other parts of the EU come here, they have access to the same support here. The European Union has been very good for our economy and those of other member states, and it will continue to be so. I believe that we disagree on that particular issue.

David Taylor: In reference to the Secretary of State's earlier announcement, does he agree that the Connexions organisation is doing a superb job in trying to tackle the category of young people who are not in education, employment or trainingthe NEETs? Connexions Leicester Shire, which has an office next door but one to mine, is a wholly owned subsidiary of Leicestershire county council and Leicester city council. This year, Connexions Leicester Shire is targeting especially white British young people who live in disadvantaged areas of west Leicester and west Leicestershire. Is it right that it should target specific subsets of hard-to-reach young people? NEET numbers do show some resistance to decline over the years.

James Purnell: My hon. Friend is right to say that the Connexions service plays a vital role in the agenda. My announcement included the need for Jobcentre Plus and Connexions to work closely together. They will work closely with young people before those young people reach the age of 18. A key part of that policy will be to raise the education leaving age to 18. We are saying that we believe that once people reach 18, if they have been out of education, employment or training for six months, they should be fast-tracked into a system whereby, if they do not find a job within six months, they will be required to do a substantial amount of work-related activity for at least four weeks. We will also be looking for providers who want to put that at the heart of their strategy to get young people back into work.

Justine Greening: Will the Secretary of State meet me to discuss regeneration on the Alton estate in my constituency? Despite his deprived areas stats and all the money that is being targeted at communities to help tackle joblessness, the subject of opportunities is being missed. Only the cohort of people in such areas is considered, rather than the opportunities that are provided afterwards in those areas for people who live there already. Will he meet me to talk through the issues so that we can make the most of regeneration in Roehampton and not miss the important opportunities for those who live on the Alton estate?

James Purnell: I know that the hon. Lady has raised the issue before and is worried that the Roehampton area has not been included in the fund. The fund was allocated according to criteria of need, and that is the right way of doing it. I am happy to look at the evidence that she has raised but, clearly, basing the distribution on need is the fairest way of proceeding.

Nicholas Winterton: Youth unemployment remains a problem. I do not want to bandy statistics about, but I would like an answer from the Minister. Macclesfield boasts one of the most advanced learning zones in the country: a virtually new secondary school; a virtually new college; and a sixth-form centre. What initiatives will the Government take to ensure that courses are available at the college, in particular, to attract young people who are economically inactive? I believe that the college and its joint facilities with the school and sixth-form centre provide a golden opportunity to encourage more young people to come into work and to stay in work.

James Purnell: Given all those achievements, I suggest that the hon. Gentleman's constituents vote Labour at the next election to ensure that the investment continues.

Philip Hollobone: Over the past five years, some 22 million has been given to permanent expatriates who live elsewhere in the European Union in the form of the winter fuel payment. That figure includes more than 12 million to permanent expatriates in Spain, Malta and Cyprus. At a time when pensioners are struggling to pay rising winter fuel bills in this country, is it not ludicrous that a large amount of public money should leave the UK in the form of winter fuel payments to go to people who live in far warmer climates?

Mike O'Brien: The people who are abroad and in receipt of winter fuel payments are, by and large, people who have worked and paid their taxes here, who have moved abroad and who were in receipt of winter fuel payments before they moved. It seems that the hon. Gentleman is advocating that we should now remove those payments from them. I have some concerns that people in warm climes are receiving payments, and we will look at that. However, it is their right to receive the payment because they received it when they were here. Is the hon. Gentleman proposing that thousands of people cease to receive payments to which they were previously entitled? We need to be clear about what he is proposing.

Vincent Cable: Following the decision of the pensions regulator to apply a longevity factor of 89 years to private sector pension funds, what assumption is the Minister making about the longevity that is appropriate to public sector pensions? What difference will it make to public sector liabilities if the age of 89 years is chosen?

Mike O'Brien: As the hon. Gentleman knows, there have been substantial changes in the way in which public sector pensions are dealt with. There have been extensions of the age at which people are entitled to receive things, and there have been changes to the way in which some of the funds have been structured. There are different ways in which public sector pension schemes are funded, and trying to apply something to the public sector that is directly related to issues to do with defined benefit systems in the private sector is misplaced. If the hon. Gentleman feels that the comparisons are direct, he needs to look at the issue with a great deal more care than he has until now.

Philip Davies: Will the Minister confirm that in 1997 67,000 people had been on incapacity benefit for five years or more and that today 1.5 million people have been on incapacity benefit for five years or more? Can he explain how the Government have managed to preside over such a culture of long-term welfare dependency?

James Purnell: I am afraid that the Conservatives have just got their figures wrong on this. As has been pointed out, they have failed to reflect the fact that there was a change in the name of one of the benefits, so they have added two completely different categories. What actually happened was that, when the Conservative party came to power, 700,000 people were in that situation, and we inherited a situation where there were 2.6 million such peoplemore than treble the number. The figure has started to fall under this Government, but we want to do more.
	That is why we are introducing the employment support allowance from October this year. Instead of judging people on the basis of what they cannot do, which is the system we inherited from the hon. Gentleman's Government, we will judge people on the basis of what they can do. There will be an earlier medical assessment at 13 weeks. There will be greater support for people who will not be expected to work, but greater requirements to look for work for everyone else in that category. This is a major reform of the systemone that was not undertaken by his Government. The reason the numbers increased was that they were happy to see them increase. We are not happy to see them increasethey are falling under usand we have now set ourselves the goal that 1 million more people will come off incapacity benefit by 2015. That is the most radical reform of the system that this country has ever seen.

Laurence Robertson: I have a number of engineering companies, particularly in the aerospace industry, in my constituency. One of the problems that they have is in attracting young people to engineering; it is not seen as the kind of work that they want to do these days, but it is extremely important to those companies. Given that more and more people are staying on at universities, but that they are sometimes failing to find jobs, what can the Government do to ensure that young people who go to university take the appropriate courses that will enable them to find work and that will also satisfy the engineering companies in my constituency that struggle to find the right employees?

Stephen Timms: The hon. Gentleman raises a very important issue. Aerospace has been a very big success for the UK economy over the past few years, and a success that we want to continue. The Engineering Employers Federation said in its recent review of the state of manufacturing that there had been something of a renaissance in UK manufacturing more broadly. The hon. Gentleman is absolutely right: we need to make the most of those new opportunities in engineering to increase employment among people and to give them access to the opportunities that are becoming available. That is why the new diploma in engineering, to which reference was made earlier, is an important step and why it is also so important that we are increasing the number of apprenticeships in aerospace and elsewhere.
	I visited Nissan in Sunderland on Friday. The company is just about to add a third shift for the production of the Qashqai vehicle. It is having to recruit 800 extra people that factory alone for that, and it thinks that another 400 jobs will be involved in the supply chain nearby. In addition to all that, the hon. Gentleman is quite right that we need to encourage young people

Mr. Speaker: Order.

Michael Fabricant: For the specific 12-month period up to today, are child poverty levels rising or are they falling?

James Purnell: Figures will be published later on this year, and the hon. Gentleman will see them when they are.

Greg Hands: Will the Minister join me in congratulating the Hammersmith and Fulham volunteer centre on the excellent work that it has been doing recently on outreach to homeless, long-term workless households and in trying to find jobs for those people in places such as the West Kensington estate? However, the H and F volunteer centre is about to have its funding reduced due to the impending end of the North Fulham new deal for communities project and the loss of 50,000 a year in funding. Will the Minister agree to meet me and representatives of the volunteer centre to discuss how the Government might be able to help them to continue their excellent work?

James Purnell: I would be happy to meet the hon. Gentleman. As he knows, we are moving towards a flexible new deal, rather than having individual programmes, which is widely recognised as the right approach to deal with people's individual needs. I believe that that approach is supported by his party.

James Gray: The Work and Pensions Committee was clear that one of the Child Support Agency's biggest problems was the IT systemthe computers were described as completely unworkable. How much of the old CSA computer system will be carried over to the new system? If the amount will be substantial, how can Ministers be certain that the new system will be any better than that before?

James Plaskitt: We have always acknowledged that IT problems have bedevilled the agency for a long time. As I said earlier, major investment in IT is taking place as a result of the operational improvement plan. A major fix of the system is taking place over the Easter period to put in place a completely new method of operation. When the new commission takes over later this year, it will inherit the existing systems and contractsmuch improvedbut it will be for the commission to decide for the long term what IT system it wants to support the arrangements that it will introduce.

Northern Rock

Alistair Darling: With permission, Mr. Speaker, I would like to make a statement on Northern Rock.
	I hope that the House will understand that it was necessary for me to issue a statement yesterday, ahead of the markets opening, so that trading in Northern Rock shares could be suspended this morning. It was also essential to allow the management of Northern Rock time to tell its employees what was happening so that the bank could open as normal this morning.
	As I said yesterday, the Government have decided to introduce legislation to take Northern Rock into a period of temporary public ownership. I took this decision after full consultation with the Bank of England and the Financial Services Authority. The draft Bill has been available in the Vote Office and the House of Lords since this morning to provide as much time as possible for right hon. and hon. Members, as well as the other place, to examine its provisions. If the House agrees, the Bill will begin its parliamentary passage tomorrow. I have also arranged for the principal Opposition spokesmen to be briefed by Treasury officials today.
	It is important for savers and depositors to be reassured that their money remains safe and secure. Northern Rock will continue to operate as a bank on a commercial basis, and it is open for business as usual today. The Government guarantee arrangements that I announced last year remain in place and will continue to do so. Borrowers will continue to make their payments in the normal way.
	I have appointed Ron Sandler as the executive chair. He is in Newcastle today and has had meetings with the company and its employees. The new board and the bank will operate at arm's length from the Government with commercial autonomy for their decisions. I will publish shortly the framework agreement that will outline how the relationship between the Government and the Northern Rock board will work.
	As I said yesterday, the board's proposals will also cover the Northern Rock Foundation, which is very important to the north-east. The board will commit to guaranteeing a minimum income of 15 million per year in 2008, 2009 and 2010. That will be paid directly by Northern Rock, as now, and would be a condition of any sale, if it were sold in that time. The new board will be asked to identify a long-term future for the foundation.
	I want to set out the reasons for the decisions that I made and to outline what the new legislation will do. Before that, let me remind the House that last September there was almost universal agreement that the Government were right to intervene to save this bank to stop its problems spreading to the wider banking system. There was also agreement that, ultimately, the long-term future of the bank must lie in the private sector. Even those who advocated nationalisation in the autumn did so on the basis that it could be only a temporary stepa stepping stoneto return the bank to the private sector when market conditions made that possible.
	Throughout last autumn, and from the start of this year, the Government wanted to test all the options and to give the shareholders and the management time to find a solution that was acceptable and that met the three principles that I set out last year: to support financial stability; to protect depositors' money; and to protect the interests of the taxpayer. I said throughout that all options, including a period of temporary public ownership, remained on the table.
	As the House will know, the Government had two private sector bids to consider. Each was tested against the option of a temporary period of public ownership to see which met our objectives and principles, including best value for the taxpayer. Both proposals involved a degree of risk for taxpayers and a very significant implicit subsidy from the Treasury, involving a payment below market rate to the Government for continuation of our guarantee arrangements and for the financing that we would put in place.
	Each proposal had its pros and cons. The Virgin proposal, for instance, would have brought in a new brand and management. However, the taxpayer would have received a share of the private sector return only if the business's value to its investors reached at least 2.7 billion. The board's proposal would have involved a similar level of subsidy, but it had other disadvantages compared with Virgin's. It would have brought in less new capital, and the business would have depended longer on Government guarantees for new retail deposits. A subsidy on the scale required would not have provided best value for the taxpayer. The private sector rather than the taxpayer would have secured the vast majority of the value created, and that would have been a poor reflection of the balance of risk borne by the two sides. By contrast, under public ownership, the taxpayer will secure the entire benefit and proceeds from the sale of the business in return for bearing the risks during this period of market uncertainty. That is why we made the decision that we did. We made the decision to protect taxpayers having weighed up the various competing considerations. In deciding which was the best option for the taxpayer, it was clear that a temporary period of public ownership was the better option.
	I will go through the contents of the Bill in more detail on Second Reading tomorrow. We have deliberately drafted it to ensure that a bank can be acquired only in certain tightly defined circumstances, and the power to do so will last for only 12 months. I have already announced a consultation that will lead to permanent legislation to deal with such situations in future. The Bill potentially applies to a range of financial institutions, but I want to make it clear that the Government have no intention at present to use it to bring any institution other than Northern Rock into temporary public ownership.
	The Bill also provides for appropriate compensation to shareholders. As I explained on 21 January, those provisions are on the basis that all financial assistance provided by the Bank or the Treasury, including guarantee arrangements for depositors, had been withdrawn and that no further financial assistance, apart from ordinary market assistance from the Bank, would be provided to the deposit taker. I believe that that is fair both to shareholders and to the taxpayer. The Bill makes provision for transfer of the bank or parts of it to the private sector.
	I remind the House that following the problems that started in the United States last summer, Northern Rock was unable to raise the billions of pounds that it needed to stay in business. We were right to save the bank and to do everything we possibly could to find a private sector buyer on terms acceptable to the taxpayer. Because of current market conditions, we are now right to take over the bank on a temporary basis, because that is what is in the best interest of the taxpayer. There were choices to be made. We could have let the bank go under, but the risks to the wider financial system, for savers and for the general public were not acceptable. Having made the decision to save the bank, maintain financial stability and protect savers, we are now taking this decision to protect the taxpayer. I commend this statement to the House.

George Osborne: Never before in the long history of his office has a Chancellor had to come to Parliament to announce the nationalisation of a high street bank. For months, the Prime Minister dithered and delayed, doing everything he could to avoid the very course of action that he now recommends to Parliament. We know why. As the Chancellor acknowledged at the Dispatch Box, nationalisation means the
	slow lingering death
	of Northern Rock
	and Britain's reputation as a major financial services centre,
	with him
	cast in the role of undertaker.[ Official Report, 19 November 2007; Vol. 467, c. 968.]
	I have three sets of questions to ask that self-confessed undertaker. First, will he reaffirm that nationalisation means that the taxpayer is
	bearing all of the risk?[ Official Report, 21 January 2008; Vol. 470, c. 1210.]
	That was the phrase that he himself used last month in the House when he argued against nationalisation. Nationalisation means that the taxpayer's risk has doubled to 110 billion, or 3,500 for every family in Britain. Every family in Britain will now own the high street bank that wrote more mortgages at the top of the housing market than any other. Every time a home owner fails to meet a mortgage payment, every family in the country will bear the cost. That is what this nationalisation means.
	Can the Chancellor tell us about the state of the 100 billion mortgage book that he wants the taxpayer to own? How many bad loans are there? The credit rating agencies now say that the losses are rising at Northern Rock. Is that true? Before we debate the Bill tomorrow, we are entitled to a full statement of the financial position of the company that we are being asked to buy. We are entitled to see the advice from Goldman Sachs that we have all paid for.
	Secondly, will the Chancellor agree that it is totally unacceptable for Northern Rock to continue with business as usual? This is now a Government bank; it can borrow and lend more cheaply than any of its high street competitors. Indeed, today it is still offering some of the best savings deals out thereit is still offering the 125 per cent. mortgages that it wrote last year. That is politically and economically unacceptable. Nationalisation can never mean business as usual. The Chancellor said in his statement that the management would be at arm's length. Why is there nothing in the Bill to prevent political interference?
	Thirdly, will the Chancellor confirm that he is actually introducing unprecedented, sweeping, draconian powers that will let him nationalise any other bank or deposit-taking institution in Britain by ministerial fiat?  [Interruption.] The Lord Chancellor should pay attention; he keeps talking about strengthening the powers of Parliament, but he is about to give the Chancellor of the Exchequer the power to nationalise any bank in Britain without coming to Parliamentnot even Michael Foot dreamed of that. It will create further uncertainty in financial markets and do further damage to Britain's reputation. If the Chancellor is giving himself those sweeping powers only to get round parliamentary procedures for hybrid Bills, he should give himself them for a week or a month, not for a whole year.
	The Chancellor had opportunities to avoid the disaster of nationalisation last autumn, and he missed them. He has the opportunity now to avoid the disaster of nationalisation by opting instead for a reconstruction led by the Bank of England, and he will not take it. It would mean 55 billion less exposure for the taxpayer, and none of this farce of business as usual; it would be like the approach that the Chancellor himself recommends for future bank rescues. But instead, the Prime Minister and his Chancellor have dithered their way to disaster. Now what they call the temporary nationalisation could, in the words of Ron Sandler, last years.
	In uncertain economic times, the British people have a right to expect decisive and strong leadership from their Government. Instead, this Chancellor has given us weakness and indecision, with humiliating reversals over capital gains tax, then non-domiciles and now Northern Rock. He has taken Britain back to the 1970s and the failed policies of Labour's past. We can safely say that he will never recover his reputation for competence. He is now politically a dead man walking and if the Prime Minister could make a decision, he would move him. What matters to the rest of us is that the British economy and its reputation abroad recovers from the Chancellor's disastrous time at the Treasury. Nationalising a high street bank is not the way to begin, and we will oppose it tomorrow.

Alistair Darling: The shadow Chancellor is increasingly someone who conceals cynical opportunism with a pretty thin veneer of abuse. One would have thought that he might rise to the occasion rather than playing petty politics with the serious matter of the stability of the banking system in this country. He has never had a consistent policy on what to do with Northern Rockevery day brings a new policy and a new stance. Last September, he and the Leader of the Opposition said that they wholeheartedly supported what we had done and that they recognised we were right to take the action that we did to stop the problem spreading into the wider financial system. But when things got difficult for them, they ran away from that support. They were in favour of administration, despite the fact that that could have provoked a fire sale with a huge loss to the taxpayer. They said they were against nationalisation, yet two days later the Leader of the Opposition said yes, he would have to consider all the options, including nationalisation. Their policy today appears to be nationalisation followed by some ill-designed plan to sort out the future of the bank. They have absolutely no coherent view about what to do with this problem. They also fail to recognise the problems that have caused the bank's underlying difficulties in the first placethe problems that arose in the American housing market that have spread to the financial markets right across the world, making it necessary for us to take the action that we have.
	The hon. Gentleman criticises the decision that I have taken today. He is entitled to take that view, but he might want to have a word with the shadow Chief Secretary, who said on television this morning:
	The Chancellor is quite right; if the private sector isn't willing to pay an appropriate value for a business then it would be wrong to hand it over at an under value.
	I am deeply grateful to him for his support.
	It is clear that the Conservatives have absolutely no idea how to deal with this problemall they can do is to come up with proposition after proposition showing their cynical opportunism. Rather than dealing with a serious problem, they have absolutely no answers whatsoever.

John McFall: I welcome the Chancellor's statement on the basis that it protects the interests of taxpayers, which the Treasury Select Committee identified in its report. Given the arm's length management that will operate under Ron Sandler, no doubt the Committee will want to receive regular updates from him and his colleagues to ensure for ourselves that accountability is the key here. Given the unique position of Northern Rock as a nationalised institution, does the Chancellor agree that accountability is extremely important in to ensure that it does not distort the financial markets at any time?

Alistair Darling: First, I thank my right hon. Friend and his colleagues on the Treasury Select Committee for the very thorough investigation and piece of work that they did in relation to Northern Rock.
	It is important that the management team led by Ron Sandler has the opportunity to make its decisions, first, to come up with a business plan, which we need to submit to Europe as part of the state aid approvals process, and then to be allowed to get on with the job. Yet again, I profoundly disagree with what the shadow Chancellor said. He seems to imply that it would be better for the bank to go bust rather than to allow it to trade and get through the difficulties that it faces. We will be in some difficulty if we go down the road of holding the management team to account for every single thing that they do. I am sure that the Select Committee will want to know about the business plan and want to discuss these things, but it is important that the management team gets to operate at arm's length from the Government and gets on with running the company, because that is the best way of ensuring that it can be restructured and refocused and can then be returned to the private sector when it is appropriate and right to do so.

Vincent Cable: After five months, the Government are now in the best position to ensure the repayment of the taxpayer's money. They were right to decide that temporary nationalisation is a better option than a bad private sale whereby the taxpayer would have underwritten the risks and the private buyer would have acquired the profits. I am tempted to say, I could have told you so, but this is too important for that. I will content myself simply with making this comment: when the Chancellor receives a large multi-million-pound invoice from Goldman Sachs for its financial advice, could he perhaps return it politely with a little note saying that he received rather higher quality advice free of charge from me and the Liberal Democrats?
	The Conservative spokesman talked about the dark satanic socialism of the 1970s, but will the Chancellor confirm that the last time a private bank was nationalised in Britain was in 1994, when the last Conservative Government acquired National Mortgage bank, paying its owners a total of 1? And was not the last major bank nationalisation in the western world undertaken by that loony left-wing Trotskyite President Ronald Reagan, when he acquired Continental Illinois bank, which was subsequently returned at a profit to the American taxpayer by the Clinton Administration?
	Clearly, choices have to be made. The Government have made theirs and we have made ours. Until today, the Conservatives had no alternative. I think that they are now suggesting public administration under a publicly owned Bank of England. What is that but nationalisation in all but name? The hon. Member for Tatton (Mr. Osborne) is so determined to keep one foot on either side of the fence dividing the public and private sector that he is in imminent danger of being castrated by the serrated edge.
	However, there are questions for the Chancellor. What sort of undertakings did he give to Sir Richard Branson and others to pay their fees for private bids? When will he commission a fully independent audit through the Bank of England to establish the quality of the assetsthe loan book for which this enormous sum of public money has been advanced? When will there be democratic scrutiny of the new business model, which could involve contraction or expansion of the bank? I hope that the changes will put an end to the extreme loans to which the hon. Member for Tatton rightly referred, which lent more than the value of property.
	In general, the Government have to face some difficult decisions. The bank will have to contract and there will be job losses. We all recognise that, but at least the bank and the north-east have some long-term hope. For that reason, we shall support the measures in Parliament, while giving constructive criticism. That is the right thing to do.

Alistair Darling: I agree with a lot of what the hon. Gentleman says. He is quite right to remind the House that there have been many occasions when Governments have thought it right to intervene to take action to preserve stability or, in some cases, to preserve vital industries. He will remember what happened in the 1970s because I seem to recall that he was in the Labour party then. He is also absolutely right in his description of the Conservatives' policy. Their policy is nationalisation. It involves nationalisation, but the hon. Member for Tatton (Mr. Osborne) has the gall to say that he is going to oppose the Bill that will bring that about. The only way he could deliver his policyin as much as it is understandable and that it will last for the next day or sowould be to nationalise, so it seems extremely odd that he intends to oppose the legislation tomorrow.
	The FSA is responsible for regulating Northern Rock and it judges the mortgage book that Northern Rock holds to be of good quality. On the business model, as I said earlier, Ron Sandler and his team will introduce a model after they have had a chance to consider the options available to them. That will have to be endorsed by the Government, because it has to be cleared by the Commission under the normal state aid rules. Once we have taken that action, assuming that Parliament agrees to it in the next day or so, I believe that there is a good chance that we can help Northern Rock to get through this period, and that seems infinitely better than the Tory options of either bankrupting it or finding some other pretty ill-defined destination for it, which make no sense to me whatsoever.

Doug Henderson: Listening to media reports this morning, it seemed as though the Conservative party was dead set on destroying the great northern institution of Northern Rock, and was prepared to see its assassination in its bitter opposition to nationalisation. However, it now seems that we are hearing different things for different audiences. I can tell my right hon. Friend that people in the north-east, and particularly the bank's staff, will welcome the announcement of the establishment of a framework agreement. He will understand the considerable anxiety among the population at large in the north-east, particularly those staff. May I press him to undertake early publication of a business plan so that stability is brought to the business at the earliest possible date?

Alistair Darling: I am grateful to my hon. Friend, who rightly sets out his concern for the future of Northern Rock and for the people who work there. I hope that the business plan can be produced as quickly as possible, but I want to give the management team time to work out a plan that actually stands up. It is better to take time to get these things right, rather than rush into something, which is what the Tories have been suggesting over the past few weeks. It is time to get a properly worked up business plan. I am grateful to my hon. Friend for his comments about the Northern Rock Foundation, which supports many organisations in the north-east. That is an important step.

Several hon. Members: rose

Mr. Speaker: I call Ken Clarke.  [Interruption.]

Hon. Members: That's you!

Kenneth Clarke: The Chancellor will recall that I supported his guaranteeing deposits last autumn, although he did it three or four days too late. However, it seemed to me and most other people that the only case for nationalisation was through an orderly run-down of the bank, with the sale of the loan book, as and when the markets permitted, to get decent value for the taxpayer. If it is genuinely business as usual and if the bank is to remain open and take deposits, why should not every sane saver in this country rush to take their savings out of other banks and saving institutions to put them into the only institution that offers competitive rates of interest, fully backed up by the Bank of England? What would that do for the reputation of the financial services industry in this country? How much profit does the Chancellor expect to make eventually out of the extraordinary venture?

Alistair Darling: I knew who the right hon. and learned Gentleman was, even if he was taken aback. He appears to support precisely what I propose: that we give the bank time to reorganise and refocus. However, I do not agree with his proposition that the bank should simply be run down. The management team needs the opportunity to restructure and refocus the bank because the market conditions have changed. On its operation in the marketplace, the state aid rules exist to ensure that it cannot abuse its position, but it is in the general interest of stability and of taxpayers to have an opportunity to work things through. If we followed the course of action that the Conservative party advocates, the taxpayer would lose substantial amounts.

Jim Cousins: Is my right hon. Friend's intention with nationalisation to grow on a successful business in the public sector or is it simply the beginning of a slow, lingering death for the business? The House is not even at the beginning of the affair. Does the statement mark a new beginning or the beginning of the end in many homes in my city of Newcastle?

Alistair Darling: Let me put it this way: we had a choice of accepting one of the two bids on the table from the Virgin consortium and from the board. However, when we examined those two bids and judged them against the option of public ownership for a temporary period, they did not stack up in value for money terms. It would have been wrong of me to make a proposal that involved significant subsidy and that, as the figures clearly showed, was not the best option. We must at all times look after three things: the financial stability of the system, security for depositors and savers, and value for taxpayers. That is why I reached the decision at the weekend that I have announced today.
	I hope that Ron Sandler and the new management team can examine the bank, ascertain what needs to be done, especially given the market conditions that it now faces, and see what we can do to refocus and restructure the business. I cannot give my hon. Friend the answer today because, as I said, the management needs time to do that. However, the alternative of accepting a bid that was not good value would have been wrong, and the suggestion from the Conservative party simply to bankrupt the bank would have been a profound mistake.

Alan Beith: I encourage the Chancellor to resist the calls from Conservative Members to run off the bank completely, and instead to keep it going as a business. I welcome his comments about the Northern Rock Foundation continuing to secure income. After all, if the north-east had been offered even a share of 50 billion in Government loans and guarantees, we could have used it to benefit the region. At least the foundation can give us some benefit.

Alistair Darling: The right hon. Gentleman is right: the Conservatives want the bank not to take any new business, which would involve it being run off. At least, that is one policy that they are advocating; it would not surprise me if they had another one by tomorrow. That sort of inconsistency would just compound the difficulties that Northern Rock faces. In relation to the action that we have taken, I am grateful for the right hon. Gentleman's support.

Stuart Bell: The Chancellor is perfectly right to refer to the sub-prime mortgage crisis in the United States and the ongoing difficulties in the financial markets. Against that background over the past five months, has he not ensured financial stability, prevented contagion, defended the interests not only of the taxpayer but of Northern Rock's depositors and savers, and provided guarantees that have not been called upon? Given that fact, will he ensure that temporary ownership is also prudent ownership and does not fall within the time scales of our 24-hour news media?

Alistair Darling: As I have told the House, if we had not intervened to save the bank last September and if it had gone down, there would have been a substantial risk of the problems that it had faced and the difficulties caused by its collapse affecting the rest of the banking system. We therefore intervened and we were right to do so, and as I have said, at that time we were supported in all parts of the House. I fully accept that the Conservative party moved from that position subsequently. In relation to the savers and depositors, we were right, too, to issue those guarantees, because we wanted to ensure that they would not lose their money. We have been successful in that, too. The third element is to ensure that we do the right thing by the taxpayers of this country. That is why I have made the proposals that I have made todayprecisely to ensure that the taxpayer's interests are protected.

Iain Duncan Smith: It is a long time since we have seen so many smiling faces below the Gangway in response to an announcement by the Chancellorhe has certainly pleased one big audience down there.
	May I press the Chancellor on the issue of competitiveness? As he said, the bank is going to trade through. He talked about it trading responsibly and not abusing its position under state control, but how will he guarantee that it will be unable to abuse that position or to continue as it has, which is what got it into so many problems in the first place?

Alistair Darling: At the risk of upsetting the right hon. Gentleman, I say to him that I am afraid that the best guarantee is the European Union state aid rules.

Ronnie Campbell: It is very important that we take notice of the work force in the business plan and ensure that their jobs in Northern Rock are assured. I can tell my right hon. Friend that they are worried about what is going to happen to their jobs. As far as the bank is concerned, tomorrow morning I will be opening an account in the people's bank.

Alistair Darling: I am surprised that my hon. Friend does not have one already, but I am sure that the bank will be pleased to hear that.

Adam Price: It is not just the people's bank that people are concerned about; it is the people's debt. We have heard the figure of 100 billion, but what is the Chancellor's estimate of the total liability to the taxpayer, including the guarantees, the loans and any shareholder compensation? Will that amount now also include subordinated debt, which also runs to some billions? He said that the FSA regulates Northern Rock, but is he content with that? The FSA is required to produce a risk analysis of building societies every six months, but where was it? Did it tell the Treasury of its concerns about the massive over-reliance on the wholesale market? If it did not tell the Treasury, heads should roll at the FSA; if it did, perhaps Ministers should be considering their positions.

Alistair Darling: As has been well documented, the FSA accepts that it should have taken action last year when it became aware that there were problems in relation to the bank. However, I remind the House that, as the Treasury Committee found, the primary responsibility for running Northern Rock lay with the directors. They got themselves into a position from which they could carry on trading only by securing access to billions of pounds of funds from the financial markets. When that became difficult and then impossible in September, they had no alternative but to go to the Bank of England. The primary responsibility for Northern Rock, as for any other bank, must therefore lie with its directors.
	On the hon. Gentleman's earlier points, Northern Rock has a good quality mortgage book, the funds that have been advanced by the Bank of England are secured against Northern Rock's assets, and as to the guarantees that I have given to depositors, and other guarantees, none of them has been called, so there has been no cost to the taxpayer.

Dari Taylor: Maintaining banking stability is critical to all of us in the House. Does my right hon. Friend therefore accept that it would be valuable to have an all-party solution to the problems that Northern Rock is facing? With that in mind, will he tell us whether the Treasury has received and assessed any ideas from the Conservative Opposition, or has it in fact received no ideas from them?

Alistair Darling: I have to tell the House that, if we were going to assess the Conservative party's policies on this matter, we would have to increase hugely the number of people whom we employ, simply because its policies seem to change every day.

Michael Fallon: Will the Chancellor confirm that clause 11 of his Bill will enable the Bank of England to offer financial assistance to any building society that might be in trouble? Is not the real signal from the nationalisation that he has announced today that from now on, any bank or building society that gets into trouble through its own incompetence can expect to be bailed out by the taxpayer?

Alistair Darling: No, that is not the position. There is provision in the Bill to allow for assistance to building societies, because that power does not exist at the moment; it seems to me prudent to include it in the provisions. The tests that have to be passed before a bank can be nationalised are quite high. There will have to be a substantial, serious threat to financial stability, or funding must have been given that has been underwritten by the Treasury, as with Northern Rock. The test that will be applied to any financial institution that is getting into difficulty is simply this: does it present a systemic risk to the system as a whole? If it does, there will be a case for Bank of England intervention; if it does not, that will not be the case. The tests that we shall apply have not changed, and they will not change as a result of the legislation.

Gerald Kaufman: Has my right hon. Friend noticed that  The Daily Telegraph says today that he is doing the right thing in bringing Northern Rock into temporary public ownership, and that his action is likely to have considerable advantages for the taxpayer? Does not the view of that Tory newspaper contrast with the vacuous blather given from the Conservative Front Bench? That is the party that rushed the nationalisation of Rolls-Royce through the House.

Alistair Darling: I remember the nationalisation of Rolls- Royce; I was not here at the time, although I am pretty sure that my right hon. Friend was. I did indeed notice the remarks in  The Daily Telegraph, although I must concede that it took me some time to get to the bit that said I was doing the right thingit was a pleasure to read it. The problem for the Tories is that they do not actually have any coherent idea of what to do in this situation. Their position changes from day to day, and from week to week. Therefore, all that we see is cynical opportunism, because they have nothing else to offer.

Peter Lilley: A recent study shows that Northern Rock is already repossessing more homes than any other major bank. Does the Chancellor still stand by the assurance that he gave me and the House that Northern Rock has a high-quality loan book? If he does, and if he believes that it has a lower proportion of bad debts but is repossessing more of them, will he, as its owner, tell its managers to pursue a less aggressive repossession policy, or does he intend to wash his hands of what the managers do and be the Pontius Pilate of the repossession business?

Alistair Darling: This is an example of the Tories trying to have it both ways at once. Half of them say that we should not be interfering in the running of the bank, while the other half say that we should interest ourselves in every single transaction. I have made it very clear that the operational decisions and the day-to-day management of Northern Rock have to be a matter for its management. That is absolutely right. I would just say to the right hon. Gentleman, as he was a member of the last Conservative Government, that there are repossessions today, and that is extremely unfortunate, but they are at a fraction of the level they were when he was a Minister.

Chris Mullin: My right hon. Friend should know that his statement will be widely welcomed, even though we are all aware that difficult decisions lie ahead. He was right to stress a few moments ago that the primary responsibility for this debacle lies with the former managers of Northern Rock. Given that that is so, does he consider it remarkable that the hon. Member for Tatton (Mr. Osborne) has uttered not one word of criticism of the previous managementthey were Tories to a man, incidentallybut has instead reserved his indignation entirely for those who are trying to clear up the mess?

Mr. Speaker: Order. I ask the House to remember that we are supposed to be putting questions to the Chancellor of the Exchequer about his stewardship of these matters.

Alistair Darling: You are, of course, right, Mr. Speaker. So, too, is my hon. Friend in his observation that the primary responsibility for Northern Rock's difficulties has to rest with those on the Northern Rock board: they were responsible for the business model and had no fall-back position once it became clear that they could not secure the funding that was needed.

John Maples: The Chancellor does not really believe all this stuff about restructuring Northern Rock, returning it to the market and giving money to the Northern Rock Foundation. His responsibility is to get the taxpayer off the 100 billion hook that that they are on, so that should be first, second, third and fourth on his list. To that endthis is a genuinely honest inquirywill he explain something that I do not understand? Why has he chosen nationalisation rather than administration? He said again today that administration would result in a fire sale, but that is not necessarily so; he could quite easily have appointed Mr. Sandler as the administrator to proceed with the policies that he wanted him to pursue. That would have given the Chancellor far greater flexibility. He would not have acquired all the other liabilities of nationalisation that he is now taking on or have had the problem of compensating shareholders. In an administration, they would simply have taken what was left, which would probably have been nothing, whereas he is now going to face endless litigation from what looks like a group of very aggressive hedge funds that are latecomers to this party.

Alistair Darling: I know that the hon. Gentleman was trying to be helpful to his party, but I have to remind him of what the shadow Chancellor said in November last year [Interruption.] I am quite sure that Conservative Members do not want to hear this, Mr. Speaker. When administration was being discussed, the shadow Chancellor said:
	The winding up of the bank would pose a significant risk to taxpayers' money...and, of course, significant risks to the jobs of those people who work for Northern Rock.
	I could not have put it better myself.

Geoffrey Robinson: Is my right hon. Friend aware that if the Opposition do not like hearing the good and sound words of  The Daily Telegraph, they might care to read the leading article in today's  Financial Times, which described his decision as sensible and non-ideological, and likely to be very successful in achieving the purposes that were set out at the beginning? Is he aware that we wish the new management well in the job that it is about take onensuring that it will be a success for the taxpayer and others who have a stake in this business?

Alistair Darling: I am grateful to my hon. Friend. I think that most people recognise that the action we have taken is right in the interests of wider stability and of the taxpayers of this country.

John Greenway: May I return the Chancellor to the questions put to him by my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) and my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith)? It is no good just saying that the state aid rules will deal with the issue of competitionthey will not. The hon. Member for Blyth Valley (Mr. Campbell) has already named Northern Rock the people's bank, so why should anybody retain support and deposits in building societies and other banks when this bank now has a Government guarantee? Will the Chancellor tell us what advice he has had from the Financial Services Authority about how to avoid any depositor thinking that all his deposit is guaranteed by the bank and not subject to the same financial services compensation scheme rules that apply to all other institutions?

Alistair Darling: Once again, half the Conservatives seem to want the bank to fail, while the other half are worried about its being too successful. I said in reply to the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) that whatever business plan is approved has to meet the European state aid rules, which are there to ensure that there is not unfair competition when an institution has a degree of support from a Government. It is important for Northern Rock to have the opportunity to continue to trade in order to get through this difficult periodand I am sure that it will be painful for the company. However, if we take the opposite view of removing the guarantees and stopping it trading or offering productsI am not sure that the hon. Member for Ryedale (Mr. Greenway) was advocating thatwe might as well put Northern Rock into administration, which would result in a significant loss to taxpayers. I cannot believe that that is his position.

Kevan Jones: Having many constituents who work for Northern Rock, I warmly welcome my right hon. Friend's announcement. May I also add my welcome to that of the right hon. Member for Berwick-upon-Tweed (Mr. Beith) for the underwriting of the commitment to the foundation? Does my right hon. Friend agree, however, that the worst possible outcome for the work force, the shareholders, the Northern Rock Foundation and, more importantly, the north-east economy would be the nonsense proposed by the Conservatives of putting the bank into administration and having an asset sale?

Alistair Darling: My hon. Friend is right. Along with other hon. Members who represent north-eastern constituents, he rightly expresses concern about the bank and its employees. I very much hope that in the next few weeks, Ron Sandler and his team will continue to have the discussions that they started today with management and employees to see what can be done in restructuring the business to ensure that it has a future. It will be difficult because the market conditions are difficult, but what we have done gives the bank the opportunity to do that and at the same time ensures that we safeguard the interests of the taxpayer. To put it into administrationto run it down, which has appeared over the past half hour or so to be the developing policy among the Conservatives, would not be the right thing to do for anyone.

Andrew MacKay: Following the Chancellor's response to my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith), and following the Chancellor's edict that it will business as usual at Northern Rock, how can he justify that Northern Rock's special position in giving a better deal to depositors is within European Union rules? Is it or is it not?

Alistair Darling: As I said in reply to the hon. Member for Ryedale (Mr. Greenway), it would be a profound mistake to remove the guarantees that we have put in place. Those guarantees ensure the stability of the bank. They also protect individual savers. Removing them is not the right thing to do. I fully understand the concern that the bank should be allowed to continue to trade, but that it should not do so unfairly. The whole point of state aid rules is to ensure that that does not happen. That is certainly our intention, as much as, I am sure, it will be the intention of the Commission.

Ken Purchase: First, may I say to the Chancellor that he has been wise to take his time before arriving at this momentous decision? That is absolutely right. People will see it as a common-sense response to a difficult position. However, does he recall, in the days before demutualisation, that the bank was a sound building society, operating a good business model with significant reserves that were squandered on a pay-out at demutualisation? Does he accept that rather than rushing into another decision, which the Conservatives would like, to return it immediately to the market, further consideration should be given to the company's mutualisation so that we return to the sanity of the days when building societies gave proper mortgages to people who required them for good purposes?

Alistair Darling: I am not sure that I can make a promise on the last point, but my hon. Friend is right that it was correct to give the management and shareholders time to come up with options and alternatives. We gave them that time. We had two bids. Unfortunately, when matched against the option of a temporary period of public ownershipI made the point many times that that had to remain on the tableit was not possible to proceed with those bids. He is right that it is important to get the correct decision.

Greg Clark: The Chancellor is right to say that the Northern Rock Foundation is a crucial charitable institution in the north-east, but before he paints too rosy a picture of its prospects, can he confirm that the 15 million funding is less than half the 31 million that it received in 2006? Can he say what will happen to the foundation's 15 per cent. stake in the bank, and whether any purchasers of Northern Rock's assets will acquire an obligation to pay funds into it as the bank has done?

Alistair Darling: I do not think anyone would maintain that the foundation's prospects have been affected by the difficulties in Northern Rock, which funded all its activities. On any view, the amount that Northern Rock was able to pay into it was going to decrease. We all recognise that it supports a great many activities in the north-east; I wanted to ensure that it had a considerable income, and although the 15 million is less than it was receiving, it is a substantial annual contribution. I did what I could to deal with that particular problem. As for the hon. Gentleman's other question about the foundation, the legislation will make the necessary provision.

David Clelland: This morning I received an e-mail from a constituent who is a shareholder in Northern Rock. He said that he was a Labour supporter who would never vote Labour again because of what the Government had done. I have not yet had a chance to reply to my constituent, but should he vote for the Liberal Democrats, who would have nationalised the bank five months ago without seeking any of the private sector solutions that the shareholders required? Should he vote for the Conservatives, who would have let the bank sink with all the consequences for shareholders and employees alike? Or should he, on reflection, continue to support the Labour Government, who offer the best solution for the bank and the long-term future of the north-east's economy?

Alistair Darling: Probably, the correct answer is the last one. Naturally we are all concerned about all those who experience a fall in the value of shares they have bought, but there is no getting away from the basic problem: these were shares in a bank whose business model was entirely dependent on the ability to raise large sums of money. Last summer, when the problem began in the international financial markets, the company had no fallback position, and it would have gone bust at that time if we had not intervened. That, I am afraid, is the stark reality, as I know my hon. Friend recognises. Today we are trying to ensure that we do the right thing by the taxpayers, while also helping the company to restructure and refocus its activities.

Philip Dunne: In his hat trick of humiliating statements, the Chancellor has told us that he is accepting the proposal in order to protect taxpayers. If that is the case, what independent assessment has the Treasury undertaken of the quality of the loan book? A year ago Northern Rock was writing mortgage business at two and a half times its market share, at a time of unprecedented house price inflation. It is highly likely that a large proportion of those mortgages will turn sour. Is the Chancellor relying entirely on the FSA's assurances that the bank is solvent, or has he bothered to do a bit of independent checking himself?

Alistair Darling: The FSA is responsible for regulating Northern Rock. Ron Sandler and his new management team will want to make their assessment relating to the revised business plan on the basis of what they know about the bank, and they will make it their business to find out all that they need to know about it.

Dennis Skinner: It was imperative for the Chancellor to intervene last year. He made the right decision, because in that very week Alliance and Leicester shares fell by a third, which signalled to anyone with any sense or political acumen that something had to be done. Now he has made the right decision again.
	The Tories were not always where they are today. In 1971 Ted Heath did not run away from taking over Rolls-Royce, and it was saved. In 1975 Harold Wilson decided to save Burmah Oil, and as a result it too was saved. That is unlike the Notting Hill finance group, who run away at every single opportunity.

Alistair Darling: My hon. Friend makes a good point. It is a pity that the Conservative party, which initially supported the action we took, subsequently decided to run away from its consequences.

Robert Goodwill: The European Commission has indicated that while the emergency loans made at commercial rates do not fall under state aid rules, the guaranteeing of deposits does, and it has given the Government six months for emergency restructuring. That six months runs out in March. For how long does the Chancellor think that the EC will condone this continuing situation before it bows to pressure from other banks and financial institutions to implement those rules?

Alistair Darling: We do have to submit a restructuring plan by March; that has been the case since last year. The hon. Gentleman touches on another important point by emphasising the problems that are faced. There have been similar difficulties in Europein Germany, the German Government and other authorities have had to take action to support their banksbecause of issues that all stem from the same source: the problems that started in America last year and have spread throughout the world.

Rob Marris: The Government have an enviable record in the last 11 years for economic stability and confidence in the economy. They took a decision last September on Northern Rock to preserve stability in the economy. What assessment has my right hon. Friend made of the stability of the UK economy? Is he aware, for example, of there having been a run on any other major bank or financial institution in the United Kingdom since last September?

Alistair Darling: My hon. Friend makes the point that this country has a very strong and stable economy. We have had more than 10 years of growth and we have very low unemployment and historically low interest and mortgage rates, which is in complete contrast to what we had in the early 1990s when the then Government lurched from one problem to another because they could not keep inflation down, they could not get interest rates down and they had unemployment of almost 3 million. No wonder they got into the difficulties that they faced then.

Business of the House

Harriet Harman: With permission, I should like to make a short business statement following on from the announcement that my right hon. Friend the Chancellor of the Exchequer has just made.
	The business for the remainder of this week will now be as follows:
	Tuesday 19 FebruaryConsideration of a Business of the House motion, followed by all stages of the Banking (Special Provisions) Bill, followed by motion to approve a local government restructuring order relating to Shropshire.
	Wednesday 20 FebruaryContinuation of consideration in Committee of the European Union (Amendment) Bill [5th allotted day]. Any selected amendments to clause 2 relating to foreign, security and defence policy.
	Thursday 21 FebruaryMotion to approve the draft Prevention of Terrorism Act 2005 (Continuance in force of sections 1 to 9) Order 2008, followed by motion to approve the draft Social Security Benefits Up-rating Order 2008 and the draft Guaranteed Minimum Pensions Increase Order 2008, followed by, if necessary, consideration of any Lords Amendments that may be received.
	The House will not adjourn until the Speaker has signified Royal Assent.
	I shall make a further business statement as usual on Thursday.

Theresa May: I thank the Leader of the House for making that business statement, but I have a number of questions about the handling of this week's business.
	As the Leader of the House announced, there will be a business motion tomorrow to programme the Banking (Special Provisions) Bill. We have already said that we will not hold up the Bill, but given that it has 24 pages, 17 clauses and two schedules, we need to ensure that it receives proper and full consideration. Will she guarantee that business will go beyond the 10 pm moment of interruption tomorrow, to ensure that debate on the Bill is not cut short unnecessarilyparticularly as while this elected House has one day to debate the Bill, I understand that the unelected other place will have two days of debate on it? Given that the Committee stage of the Bill will come immediately after Second Reading, what will be the timetable for the tabling of amendments?
	Despite the length of the Bill, a lot of detail will still be dealt with by order under the negative procedure. Members need to be able to see that order before they debate the Bill, so will the Leader of the House ensure that the draft order or orders are available to Members in the Vote Office tomorrow morning? Given the importance of the legislation to so many people, and to the reputation of London as a financial centre, can we have a commitment that the order will be subject to a full debate on the Floor of this House, rather than that taking place in Committee with a limited number of Members being able to take part? When will that debate on the orders take place? Will she consider changing the business for this Friday, so that we can debate the orders then? Failing that, will she commit to holding that debate on the Floor of the House next week?
	Following the change to tomorrow's business, when will the sixth allotted day of debate on the European Union (Amendment) Bill take place? Will the Leader of the House guarantee that the House will still have the same amount of timethe same number of days' debate on the Floor of the Houseon that Bill as had previously been set aside?
	Over the past months, the Government have dithered and delayed on Northern Rock, but the House needs proper time to consider the Banking (Special Provisions) Bill. Will the Leader of the House guarantee that the House will be given that time to consider it, and the orders pertaining to it, in full?

Harriet Harman: Draft orders will be laid in the usual way by the Chancellor of the Exchequer before the House rises today. I shall give the House next week's business in the usual way in the business statement on Thursday, but I can say that there will be no less debate on the European Union (Amendment) Bill than was originally anticipated. As the right hon. Lady will understand, it will be moved back by a day, but we do not expect to curtail the debate that we had scheduled on that important Bill.
	As far as consideration in this House and the other House is concerned, the right hon. Lady will know that the procedures of the other House are a matter for it. I know that she will understand that, the decision having been made by the Government on Northern Rock, it is important that we act expeditiously in order that we can have certainty and business as usual, at no loss of confidence to customers and staff. The decision having been made, it is important that this House turn its attention to scrutinising the Bill on the matter and to making its decision as quickly as possible.

Simon Hughes: We welcome the statement by the Leader of the House and the intention that this important Bill should receive Royal Assent by the end of this working week. That seems absolutely the right objective. It is a substantial Bill and potentially deals with any bank, and building societies as well.
	In addition to the questions asked by the right hon. Member for Maidenhead (Mrs. May), may I ask the Leader of the House for a couple of other assurances relating to the handling of the Bill in this House? There is usually a difficulty with amendments if we go straight from Second Reading into Committee on the Floor of the House. Can she assure me that there will be an opportunity for Members of the House to take advice on amendments from Clerks from now until then, so that they can be cleared as being in order, and that there will be short interruptions between Second Reading and Committee stage, between Committee stage and Report and between Report and Third Reading, so that people can be fully aware of exactly what the state of the Bill is and what has happened?
	Will the Leader of the House be clear that if colleagues around the House, particularly but not only from the north-east, are willing, able and concerned to debate the matter way beyond 10 o'clock, we absolutely should not impose any artificial restrictions? We should be willing and able, as we have regularly been in the past on far less important legislation, to go through the night if that is required, and to have until 11.30 on Wednesday morning to deal with the Bill at its first time before us.
	On Thursday's business, I welcome the fact that the Leader of the House expects the Bill to come back to us, if there are any Lords amendments, on Thursday. Because we have two other important pieces of business, on terrorism matters and social security uprating, which by tradition and by arrangement are fixed in their time, may I suggest that, with the consent of both Opposition parties, she might agree that we take the Bill first on Thursday, if it is ready and if there are amendments from the Lords? I am aware that a second day of debate may be provided for there, but it is important that if there are amendments, we have the time to examine them and deal with them properly. The Leader of the House knows that we support the Bill and will not obstruct it at all, but it has to be properly debated. It is hugely important not just for Northern Rock but for the whole banking and building society industry.
	My last point is on the knock-on effects of the Bill. I completely understand that the topical debate on Thursday will be lost, as that is a reasonable conclusion. However, because the timetable for the European Union (Amendment) Bill has been knocked back one day, will the Leader of the House give Opposition parties a half-way assessment of the timetabling of the second half of the Bill in Committee, to see whether we can reach a more satisfactory agreement about the timing for the restand most controversial bitsof that Bill? That might mean fewer complaints that the Government are steamrollering that Bill through the House.

Harriet Harman: I have announced that we will have a Business of the House motion, which will be debatable and which will be tabled before the House rises so that hon. Members have a chance to consider it. There will be a debate on that motion tomorrow.
	I thank the hon. Gentleman for his support for the Bill and I agree that it has to be properly debated, but it also has to be brought in expeditiously to achieve the desired effect. As for the question of when on Thursday we should consider any Lords amendments, we have scheduled that as the last business, because if it were the first business we might not know whether the Lords have concluded their consideration and agreed any amendments. It is therefore important for us to deal with the other issues first and then come to the question of any Lords amendments later.
	On the issue of tabling of amendments, I do not accept the argument for a gap after Second Reading. My right hon. Friend the Chancellor placed a draft Bill in the Table Office this morning, so that hon. Members could consider its terms. I am sure that they will be able to obtain the advice of the ever helpful Clerks on what amendments will be in order. Hon. Members will be able to table amendments tomorrow.

Rob Marris: I welcome the business statement and I also welcome the fact that the draft orders will be available tonight. When I checked with the Public Bill Office and the Table Office an hour and a half ago, the explanatory notes were not available. This is a 24-page Bill and it is quite technical, so while I congratulate the Treasury team and the draftspeople on what they have done with the draft orders, can my right hon. and learned Friend say when the explanatory notes will be available for Members?

Harriet Harman: The explanatory notes will be available right away, if not sooner. They are very important and I will ensure that they are available as soon as possible today.

Patrick Cormack: Why does the Leader of the House not take the House properly into account? Why not let us have the Second Reading of the Bill tomorrow and the remaining stages the day after? We cannot table amendments until after Second Reading. It is important that the Bill is properly consideredI speak as one who is not fundamentally opposed to itand therefore all that the Leader of the House has to do is have a slightly more radical reshaping of the next few parliamentary days, perhaps into the beginning of next week. We could have the Second Reading tomorrow, with a vote at 10 o'clock, and the remaining stages the day after. I commend that proposition to the Leader of the House.

Harriet Harman: The House will understand that the Bill needs to be considered in this House and in the House of Lords. We have to be sure that we do not prolong any uncertainty and that we come to a swift conclusion. Of course, I have taken into account how the Bill should be dealt with in the House. We want proper scrutiny as well as an outcome that takes place as expeditiously as possible. However, the hon. Gentleman will know that it is not unprecedented in such situations for a Bill to be dealt with in this way. I have a list of Billsit is far to long for me to read out to the Housethat the House was asked to consider in one day because of the circumstances that arose. The hon. Gentleman will be aware that that is the case. The way in which we are proceeding is necessary and it is not unprecedented.

Kenneth Clarke: The Leader of the House has made it quite clear that she will allow debate only tomorrow and she has refused to answer the question of whether the debate will go beyond 10 o'clock. Her manner, supported by the Chief Whip's body language, makes it quite clear that debate will not be allowed to go beyond 10 o'clockonly, as far as I can see, because the Chief Whip wants to allow the Labour party to go home at 10 o'clock tomorrow evening.
	The Leader of the House was present for the statement a few moments ago and she saw that the Chancellor of the Exchequer was quite unable to answer a number of questions about how the bank will maintain business as usual. Most of the replies were party political hits at what the Conservative party was supposed to be doing or not doing. There was no explanation of what business as usual will mean for the bank. If every stage of the Bill will be taken in six hours tomorrowwith full parliamentary scrutinythat surely reduces the handling of the decision to a parliamentary farce after it has taken so long to come to the rather startling decision to nationalise a bank for an indefinite period, putting huge sums of taxpayers' money at risk.

Harriet Harman: The right hon. and learned Gentleman has been in this House long enough to know that on occasions the Government can ask the House to act decisively when action is needed in respect of a certain situation once we decide that we want to ensure that the uncertainty is as short as possible and that we will bring in a Bill that will give the Government powers to act. He will know that tomorrow will involve the Bill's Second Reading and its consideration in Committee. We will discuss the powers that will be taken by the Government. There will be further debate on the exercise of those powers, no doubt, as the situation unfolds.

Points of Order

Theresa May: On a point of order, Madam Deputy Speaker. May I seek your guidance on a point of clarification about the exchange that just took place on the tabling of amendments to the Bill? The Leader of the House did not answer the question about when it would be possible to table amendments to the Bill. Normally, amendments can be tabled only after Second Reading has been completed. Tomorrow, we will consider a business motion and then Second Reading. At what time will it be possible for hon. Members to table amendments to the Bill for consideration in Committee?

Patrick Cormack: Further to that point of order, Madam Deputy Speaker. May we also have some guidance on the precise times that are being proposed, first, for Second Reading and, secondly, for Committee?

Simon Hughes: Further to that point of order, Madam Deputy Speaker. If I understand the position, amendments cannot be tabled formally until after Second Reading. Will you give us guidance and advice on how long the House authorities will need to supply them to us in a printed form so that colleagues have a chance to look at them and so that you, your colleagues and Mr. Speaker can order them and decide which are selectable and which should be selected? Would it therefore be possible, from your point of view as Chair, to allow the House to be suspended for half an hour or however long it takesas has happened on many occasions in the pastwhile we get our acts together and know what we are about to do to this important Bill?

Madam Deputy Speaker: First, I shall deal with the two points of order about the tabling of amendments. I am advised that the Public Bill Office will be able to receive and advise Members about the tabling of amendments with effect from this afternoon and this evening. I hope that that addresses the concerns raised by the two hon. Members.
	Sir Patrick, there was quite a lot of noise. Would you mind repeating for me your point of order?

Patrick Cormack: Thank you, Madam Deputy Speaker. I asked whether the House could have some indication today about how much time we will have for the debates on Second Reading and in Committee.

Madam Deputy Speaker: I must advise the hon. Gentleman that the issue that he raises is a matter for the Government; it is for them to table a motion. I am sorry that I cannot be more helpful than that.

Philip Hammond: On a point of order, Madam Deputy Speaker. During the previous statement, the Chancellor quoted me as having said something on the television this morning. He quoted, quite rightly, me saying that it would be wrong to hand over Northern Rock at an undervalue to a private sector organisation. He implied that I thus approved of his policy. Just for the record, may I read a previous sentence that I had said [ Interruption. ]

Madam Deputy Speaker: Order. I need to hear the point of order.

Philip Hammond: I want to make it clear that the Chancellor was taking my words out of context. I said:
	We think that the better solution would have been to allow the Bank of England to take control of Northern Rock, to effectively lead a protective administration of Northern Rock, without taking it into public ownership.

Madam Deputy Speaker: That is not a point of order for the Chair, but the hon. Gentleman has placed on the record the point that he wanted to make, and the comments have been heard by those on the Treasury Bench.

Orders of the Day

Health and Social Care Bill

[Relevant document: T he Eighth Report from the Joint Committee on Human Rights of Session 2007-08, Legislative Scrutiny: Health and Social Care Bill, HC 303.]
	 As amended in the Public Bill  Committee , considered.

New Clause 1
	  
	Certain regulated activities to be functions of a public nature

'A regulated activity under this Part shall be deemed to be a function of a public nature for the purposes of section 6 of the Human Rights Act 1998 (c. 42) where it is performed wholly or partly at public expense and pursuant to statutory powers.'. [Mr. Dismore.]
	 Brought up, and read the First time.

Andrew Dismore: I beg to move, That the clause be read a Second time.

Madam Deputy Speaker: With this it will be convenient to discuss the following: New clause 2 Human rights framework for Commission
	'The protection and promotion of human rights shall be central to the performance of the functions of the Commission.'.
	New clause 4 Health and social care standards: content
	'(1) Standards set by the Secretary of State under section 41 shall
	(a) expressly state that all persons for whom health or social care services are provided are entitled to respect for their rights and that service providers (registered in accordance with Chapter 2) have a responsibility to respect such rights;
	(b) require that service providers respect the rights of persons for whom health and social care services are provided;
	(c) require that service providers provide their staff, whether employed directly or indirectly, with appropriate education and training in relation to respecting the rights of service users;
	(d) require service providers to specify and publish the procedures for making a complaint by any person about a regulated activity;
	(e) require service providers to put in place appropriate procedures for ensuring that any person who is aware of any failure to respect any other person's rights in relation to a regulated activity being conducted by that service provider to report such a failure to a designated person;
	(f) require service providers to ensure that, where any person is being discharged from a health care service to a social care service regulated under this Part, the rights of such persons are fully respected; and
	(g) require service providers to disseminate the standards set under this Part which are applicable to them to users of their services.
	(2) The Secretary of State may prepare and publish statements of standards in relation to the provision of health care and social care dealing with matters other than those listed in subsection (1).
	(3) In this section, a designated person is a person designated by a provider of health or social care services to receive and resolve complaints.'.
	Amendment No. 11, in clause 2, page 2, line 13, at end insert
	'(bb) the availability and adequacy of advocacy services relating to the bodies it regulates,'.
	Amendment No. 8, page 2, line 18, at end insert
	'(da) the need to improve the range and quality of information provided by health care and social care services to users of those services about their rights;'.
	Amendment No. 5, page 2, line 28, after second 'the', insert 'rights and'.
	Amendment No. 3, in clause 16, page 7, line 28, leave out 'may' and insert 'shall'.
	Amendment No. 4, page 7, line 32, after 'safety', insert ', rights'.
	Amendment No. 6, in clause 42, page 21, line 2, after 'quality', insert
	'including, without limitation, respect for the rights of any person'.
	Amendment No. 7, in clause 92, page 46, line 12, at end insert
	'rights includes human rights under the Human Rights Act 1998 (c. 42).'.
	Amendment No. 14, in clause 108, page 54, line 3, after 'safety', insert 'rights'.
	Amendment No. 15, in clause 120, page 65, line 25, at end insert
	'(1A) The appropriate Minister shall by regulations make provision in relation to awareness of, and training in, human rights in accordance with this section.'.
	Amendment No. 16, in clause 122, page 66, line 16, at end insert
	'rights include human rights under the Human Rights Act 1998;'.
	Amendment No. 17, in schedule 6, page 138, line 29, at end insert
	'(3A) The OHPA shall have regard to the desirability of improving the awareness of, and training in, human rights of its members.'.
	Amendment No. 18, in schedule 9, page 165, line 27, at end insert
	'(ea) awareness of, and training in, human rights;'.

Andrew Dismore: I also wish to speak in support of new clauses 2 to 4 and amendments Nos. 3 to 18. These new clauses and amendments have been tabled in my name and that of the hon. Member for Oxford, West and Abingdon (Dr. Harris), who cannot be here because he is away on Select Committee business, on behalf of the Joint Committee on Human Rights, which I chair and of which he is a member. As hon. Members will know, we scrutinise all Government Bills for their compatibility with the Human Rights Act 1998 and the UK's international human rights obligations. We report on the most significant human rights issues, and we have now begun to publish amendments to give effect to our recommendations. Our new clauses and amendments deal with omissions from the Bill. We expect to publish another report on the Bill shortly, commenting on some of the proposals in the Bill, particularly those to do with public health.
	New clause 1 deals with the scope of the Human Rights Actin particular, the meaning of the term public authority, which has become somewhat restricted, far more so than originally intended, and is consequently an extremely important issue. My Committee has published two reports in recent years on the meaning of the term public authority in section 6 of the Human Rights Act. That section requires public authorities to act in a way that is compatible with the convention rights set out in the schedule to the Act. The definition of the term public authority includes
	any person certain of whose functions are functions of a public nature.
	What constitutes a function of a public nature is not further defined in the Human Rights Act. When the issue was discussed during the passage through Parliament of the then Human Rights Bill, it was clearly understood that that provision was intended to cover private sector providers of publicly funded servicespublic services that had been contracted out to the private sector or wholly privatised, for example.
	A series of court cases, starting with the so-called Leonard Cheshire case and culminating in the judgment by the Law Lords in the YL case in June 2007, has narrowed the scope of the Human Rights Act as originally intended, particularly in relation to care homes. The YL case concerned the eviction from a private sector care home of an elderly and frail old lady whose care was paid for by Birmingham city council. By a majority of three to two, the Law Lords ruled that the person concerned could not bring an action against the care home under the Human Rights Act, over the infringement of her rights under article 8 of the conventionthe right to respect for her private life and home. They said that her claim lay solely against the local authority that had funded her care. The 1998 Act therefore does not apply to private bodies, and the Law Lords found that that included private care homes, even for publicly funded residents.
	In our March 2007 report on this subject, we concluded that there was a strong case for a separate interpretative Act that would clarify the meaning of the phrase functions of a public nature in the Human Rights Act. The outcome of the YL judgment has served only to reinforce our concerns and emphasise the need for the Government to act urgently, to reinstate the originally intended scope of the Human Rights Act. That is especially the case given that the Government's strategy of seeking a positive judgment in a higher court has manifestly failed to deliver the desired outcome.
	Since the YL judgment, Ministers have expressed agreement in principle with our position that the current state of the law is unsatisfactory, especially for elderly care home residents, who are an especially vulnerable group that the Human Rights Act should protect. For example, the Minister of State, Department of Health, my hon. Friend the Member for Exeter (Mr. Bradshaw), said in Committee that the Government were
	committed to amending the Human Rights Act to ensure that all independent providers of publicly funded care homes are covered by it. [ Official Report, Health and Social Care Public Bill Committee, 15 January 2008; c. 200.]
	I introduced a private Member's Bill in the last Session that would have clarified the scope of the Human Rights Act. During its Second Reading debate in June 2007, the then Minister, who is now the Solicitor-General, said that the Government were committed to taking action that year. Unfortunately, they have not moved quickly to clarify the scope of the Human Rights Act. Instead, they propose to bring forward a consultation on the issue as part of the Green Paper on a possible British Bill of Rights and responsibilities. We have been told that the Green Paper will be published in the first half of this year, so it seems pretty clear that concrete proposals will not emerge from the consultation exercise before the next general electionno matter when that happens to be.

Kelvin Hopkins: I want to reinforce my hon. Friend's point, with which I totally agree. It is almost 10 years to the day since the then Home Secretary, my right hon. Friend the Member for Blackburn (Mr. Straw), said that public authorities should extend to private providers fulfilling public functions. Some 10 years on from that commitment, it is time for us to act accordingly.

Andrew Dismore: I think that everyone believed that that was the case until Leonard Cheshire put a question mark over it and the YL case put a lid on it. It is only since last June that we have become significantly aware of how serious the problem is and how urgent it is that we resolve it.
	My Committee's preference remains for the scope of the Human Rights Act to be clarified by means of a separate Act dealing solely with the wider issue of the meaning of public authority. That would have the benefit of dealing with the problem of scope across the board, rather than on a piecemeal basis. It would help other vulnerable groups that are deprived of protection by the ruling, the implications of which are very broad. Such people would include tenants of housing associations and social housing, and children under special educational needs statements whose needs are met in independent schools. It would also ensure that the law in this area was consistent throughout the United Kingdom. I have brought forward my private Member's Bill again in this Session, and I urge Ministers not to delay in tackling what are, I accept, a complex range of issues.
	In the absence of a general solution to the problem, however, my Committee supports an interim solution for the health and social care sector, given the urgency of the issue. In our report of last summer on older people in health care and the services provided to them, we found that 21 per cent. of care homes still did not meet basic minimum standards. We set out a catalogue of abuse, neglect, carelessness, lack of privacy, dignity and confidentiality, and downright discrimination against the elderly. The elderly would be protected from all those things by the Human Rights Act, but given the implications of the YL case, those in private sector homes have no such protection under the Act.
	My hon. Friend the Member for Luton, North (Kelvin Hopkins) moved an amendment in the Public Bill Committee that would have defined all providers of health and social care as public authorities for the purposes of the Human Rights Act. The amendment had the support of the Equality and Human Rights Commission and most of the non-governmental organisations. My Committee is sympathetic in principle to the substance of the proposal. The provision of health and social care is subject to a stringent regulatory regime that involves registration, supervision and inspection. We agree in principle that that should be sufficient to attract the protection of the Human Rights Act. We are left with an anomaly of two elderly residents in the same care home: one would be protected because she was being funded by the local authority, but the other would not be protected because her assets were more than 21,500. Such a situation was pointed out by Help the Aged in its briefing for today's debate.
	Such an amendment, however, would extend the protection of the Human Rights Act to self-funders and would go well beyond what Parliament intended when it passed the Human Rights Act. It would raise wider questions about rightssomething that has become known as horizontality in human rights jargon. We believe that such an issuethe question of whether private individuals can enforce their human rights against other private individuals or companies that are not public authoritiesshould be considered as part of the wider debate on the Bill of Rights. Most people do not realise that the Human Rights Act applies to public bodies, not the private sector generally. There is a strong case for horizontality, but the original Human Rights Act did not provide for that. We are simply trying to restore the position to what it was before the Leonard Cheshire and YL cases.

Kelvin Hopkins: Is it not a problem arising from privatisation that people not only find themselves in the private sector but have their Human Rights Act coverage removed as well?

Andrew Dismore: Yes, that is a consequence of the YL case. During a Liaison Committee sitting, I put that point to the former Prime Minister. He said that such a situation would be severely anomalous, and that people with publicly funded places in the private sector ought to be protected by the Act, as not protecting them would militate against contracting out and privatisation as ways to deliver public services.
	Our other concern about the broad amendment moved by my hon. Friend the Member for Luton, North to encompass self-funders in the health and social care sector is that it would do little to fix the problem for other vulnerable groups such as those whom I have described, and might support the false impression that nothing further needs to be done to rectify the anomaly. New clause 1 proposes restoring, for the health and social care sector pure and simple, the Human Rights Act's original intention, which is that the Act should cover private-sector providers of publicly funded services, under arrangements made pursuant to statutory powers. I hope that the Minister will consider carefully the new clause and its purpose. I hope that he will accept it, but if he is unwilling to do so, I urge him to tell the House today that he will undertake to introduce his own amendments to achieve the same effect in the other place.
	The other new clauses and amendments that I have tabled are intended to implement the recommendations in our report, The Human Rights of Older People in Healthcare, published last summer. We described how the use of human rights can be a powerful lever to improve the quality of services, as well as guaranteeing in their delivery basic concepts such as dignity and respect for the elderly in hospitals and care homes. As I said, the report gave graphic evidence of abuse and showed that many homes are not compliant with existing regulations. We said that the care standards regulations should require care homes to respect residents' human rights. The regulations governing the operation of health and social care providers, which deal with matters including staff training and the handling of complaints, require that the health, safety and welfare of service users be secured. We recommended that users' human rights should also be central to the operation of health and social care providers, and amendments Nos. 3 and 4 are designed to achieve that.
	We recommended that the new Care Quality Commission should adopt a human rights framework to underpin and inform its work and make it more effective in fulfilling its statutory duties. We were disappointed that the Government's reply to our report did not address that issue adequately. New clause 2 and amendments Nos. 5 to 7 would ensure that the protection and promotion of human rights are central to the new commission's performance of its functions. If the Minister cannot accept the amendments, I should be interested to hear why he thinks our proposals are unnecessary. Help the Aged has said clearly that its main concern is the YL loophole. Notwithstanding that, it believes that the CQC can and should promote and protect human rights through its own work, saying:
	It is vital that the CQC takes a human rights-based approach,
	and that
	this vital remit should be explicit in the legislation...CQC's work on human rights should go far beyond that of any normal public body. Respect for and promotion of human rights should be fundamental.
	Help the Aged welcomes the amendments that I have tabled.
	The outgoing Commission for Social Care Inspection also supports our approach, saying:
	The new commission should place the rights of the people who use services and their carers at the heart of its work and they should have clear rights of access to it.
	Our report on the Bill published in February clearly recommended that the
	merged inspectorate...should adopt a human rights framework,
	and we were disappointed by the Government's response, which said:
	The Department of Health will not be specifying the precise work programme of the new regulator, but will expect compliance...to form an important element of its work.
	There are three problems with that. First, putting the human rights of health and social care users at the heart of the commission's work is not equivalent to specifying the precise work programme; it is more fundamental. Secondly, compliance with the Human Rights Act is a legal requirement, not simply something that the Government can expect to happen. Our concern is to ensure that human rights influence the work of the new commission across the board and are not seen simply as a tick-box compliance exercise.
	Finally, our report concluded that the Healthcare Commission should not view the 1998 Act as one of the large number of sets of regulations to which it is subject. We said that it should instead regard the framework created by the Act as overarching and fundamental to all its work. We regret that the Department of Health failed to address that point. It simply restated the current positionthat the Act is seen as just another statute applicable to public bodies and demanding compliance, rather than as the culture change that we recommended in last summer's report on the human rights of the elderly.
	We have seen the point come through strongly in the evidence that we have been taking on access to services for adults with learning disabilitiesan issue on which we hope to report in a few weeks' time. I am pleased that the CSCI fully agrees with our conclusions. I hope that the Minister will reflect on that and agree with us that it is essential that the issue becomes an overarching part of the commission's work.
	Amendments Nos. 8 and 11 deal with the functions of the new commission. Amendment No. 8 would require it to take into account the
	need to improve the range and quality of information provided by health care and social care services to users of those services about their rights.
	That is crucial. Without clear and accessible information about how human rights apply in hospitals and care homes, service users will not be in a position to challenge how they are treated or to know how to seek redress. We have been particularly concerned about older people and people with learning disabilities, but accessible information is essential to secure the protection of the human rights of us all.
	We have all seen the signs in public buildings saying that staff are entitled to be treated with dignity and respect. However, we do not often see signs that say that service users, patients or relatives are entitled to be treated with dignity and respect by staff. That, however, should be part of the information process. A lot of hospitals, including those in my constituency, give leaflets to people as they arrive about how they can expect to be treated, but not about their rights in respect of how they will be treated. Such information is essential if people are to be able to enforce those rights.
	We also recommended that in undertaking its work, the new commission should take into account the provision of advocacy services. Amendment No. 11 deals with that issue. The Government share our view of the importance of advocacy for older people in health care as well as in other contexts. The important role that advocacy can play in supporting vulnerable people in health and social care will be reinforced by a statutory reference to advocacy in the Bill.
	New clause 4 relates to health and social care standards. The Bill does not require the Secretary of State to publish care standards or indicate what the content of those standards might be. We recommended that the CQC should apply a single set of standards for health and social care in relation to issues engaging the human rights of service users. New clause 4 is our suggestion of what a human rights standard might look like. It includes requirements in respect of: staff training on respecting the rights of service users; the publication of complaints procedures; a duty on people to report any failure to respect human rights that they see; discharge arrangements; and the publicising of the standards that apply. If the Minister sees a problem with those requirements, I would be grateful if he told me what it is.
	Finally, we recommended that a basic understanding of how the 1998 Act requires the protection of basic principles such as dignity, fairness, respect and equality should be included in the qualifications, accreditation and re-licensing of health professionals; amendments Nos. 14 to 18 seek to achieve that.
	Achieving effective human rights protection requires a combination of different measures operating in different ways to make human rights considerations more central to the decision-making processes of health and social care providers and the new regulator. I urge the Government to accept in principle that the Bill should be amended to reapply the 1998 Act to publicly funded residents of private sector care homes. I also urge him to consider seriously our other amendments, all of which are intended to protect the rights of extremely vulnerable people in the health and social care sectors.

Sandra Gidley: We are debating one of the enduring themes of the Bill. In Committee, Members on both sides made several attempts to beef up its human rights aspects. Most of us were concerned about the fact that 90 per cent. of care homes are run by the private and voluntary sector and are therefore not covered by the Human Rights Act 1998. That was never Parliament's intention when the legislation was introduced, but case law and decisions in the courts have brought us to where we are today.
	It is right and proper that we try to amend that, but there is also a wider problem that probably cannot be dealt with in this Bill. We need to think of ways to avoid a situation whereby people can sit side by side in the same private nursing home with different rights because one person is funding their own care and the other is having it paid for by the state. The Minister has been genuinely sympathetic as regards this state of affairs, and it may be easier to deal with it in stages. However, it is worth pointing out that it has been allowed to exist for far too long. We missed an opportunity with the Equality Act 2006, when several amendments were tabled, and the private Member's Bill promoted by the hon. Member for Hendon (Mr. Dismore) never saw the light of day. We would not be doing our duty if we were to allow yet another opportunity to slip by. If we leave it all to a consultation as part of a Green Paper on a possible British Bill of Rights, that may be too little, too late.
	It is helpful that the Joint Committee on Human Rights has considered the Bill in such detail. I thank hon. Members for tabling the amendments, because they give us a chance to debate the issue once more. In the summary of its report, the Committee says:
	Although the Committee prefers a general solution to clarify the meaning of 'public function' in the HRA, it also sees the need for an interim solution in the Health and Social Care Bill. The Committee is sympathetic in principle to an amendment moved in Committee to make all providers of health and social care public authorities for the purposes of the HRA. But this may go beyond what Parliament intended.
	That sums up the situation very neatly. The fact that this presents a difficult challenge does not mean that it is not worth doing.
	I welcome new clause 2, which would make it clear that the new commission should adopt a human rights-based approach. It will have to deal with a wide range of legislation, and it is important to many that the human rights aspects are not just a tick-box exercise to be thought about afterwards. The thrust of its work should have human rights principles at its core.
	I am disappointed that new clause 3 was not selectedindeed, I am disappointed that several new clauses and amendments were not selected, but perhaps a little more of that laterbecause its inclusion would have sent a clear message to providers that the CQC could investigate any transgressions of the Human Rights Act. If there is a problem with the amendment, it is that it does not deal with the devolved Governments. I am slightly uneasy about supporting a situation whereby there are potentially weaker human rights in the devolved nations, and I should like that to be addressed.
	Certain comments in the Committee's report do not require legislation to implement but should nevertheless be borne in mind. I was struck by the emphasis on accessible information about human rights, and how that applies to health care settings. Such information will be available for care home residents, relatives, carers, advocates and the public as a whole. At the moment, the professionals involved know what is required of them, but it is sometimes not set out in black and white. Members of the public do not feel empowered, and making more information available to guide them through the process, letting them know what is acceptable and what is not, will do them a great service.
	I did not quite catch whether the hon. Member for Hendon planned to press his new clause to a vote. As a matter of principle, we would want to support it, despite our reservation that the devolved nations are not included.

Joan Walley: I welcome the opportunity to speak briefly on this group of amendments and new clauses and I say to my hon. Friend the Minister that I support the spirit of the proposed changes.
	I would like to consider briefly aspects that relate to the trend of contracting out and privatisation of health and social care services. At a time when an increasing number of public services are provided by the private sector, it is essential that we get the Bill right. I am conscious that this is not the final opportunity that we will have to debate the matter, and I am speaking now to implore my hon. Friend the Minister to take into account my specific concerns on issues of detail, which relate specifically to subsection (2) of new clause 4. If the spirit of that provision were adopted by the Government, the Secretary of State would
	prepare and publish statements of standards in relation to the provision of health care and social care dealing with matters other than those listed in subsection (1).
	I would like to consider that measure in relation to the provision of non-emergency ambulance services. My concern stems from a particular state of affairs that has existed in north Staffordshire and Stoke-on-Trent for a long time, where patient transport services are contracted out. I seek clarification from the Minister during this debate, and during the course of the progress of this legislation, on the details concerning transport.
	I have examined the Bill, but I did not have the privilege of serving on the Committee that considered it. Clause 4(3) refers to transport services for elderly and disabled people as being
	connected with the provision of health...care.
	Therefore, I am assuming that that will be a regulated activity that has to be registered with the commission. The Bill does not make explicitperhaps the Minister could be helpful by clarifying this so that it will become apparent through subsequent readings of  Hansardwhether that will include all the associated facilities for providing such a service, such as staff accommodation and depots.
	Clauses 11 and 12 deal with registration regulations, and clause 16, deals with the regulation of regulated activities, and although there is a need to register, I can see nothing elsewhere in those clauses that would require the commission to consult other agencies, such as the local environmental health authority, as to whether the application for registration should be granted or refused. Perhaps I should say at this point that I speak as a vice-president of the Chartered Institute of Environmental Health. I would like the Minister to set out the role that he anticipates for local authorities with regard to information they might have on whether private providers of some regulated services are suitable. For example, I would like to know what account the commission can take of issues such as food safety, hygiene or health and safety matters. If the Minister considered clause 4(3)(b) in detail and perhaps providing for associated facilities after transport, that might be a way in which to tackle some of my concerns and those of others about the matter.
	If the Minister could clarify the issue, it would give me some sense of security that depots and staff rooms associated with private ambulance services would be included in the regulated activity and taken into account in the registration process so that we could deal with unhygienic facilities, if necessary. Much legislation relates to health and safety at work and there is a procedure for considering the health and safety at work aspects of the measure. However, when we deal with the most vulnerable people in our constituencies, it is essential that we have all the necessary support. I implore the Minister to give some comfort about section 6 of the Human Rights Act and facilities associated with the private transport provision of non-emergency ambulance services.

Kelvin Hopkins: I am pleased to support the amendments, which my hon. Friend the Member for Hendon (Mr. Dismore) proposed so competently and ably. Indeed, they reflect amendments that I tabled in Committee, although I tried to go slightly further than my hon. Friend in that they would have covered all residents of private care homes.
	Of course, I understand my hon. Friend the Minister's concern about the difficulty of covering self-funders because the Human Rights Act specifically covers relations between the individual and the state, and self-funders are, by definition, private residents paying a private concern to care for themthe state is not directly involved. However, I believe that we should find a way to ensure that all residents of care homes are covered by the Human Rights Act. At the moment, if one is in a care home that is privatised, or moved from a public to a private care home, one is removed from coverage of the Human Rights Act, and that is unacceptable. Even if the Government tabled amendments along the lines suggested by my hon. Friend the Member for Hendon, the self-funders would still not be covered. I have a possible solution, which I will urge on the Minister later, but I will not spring that surprise on him just yet.
	The problems arise from two fundamental factors, about which I was not happy when they occurred. The first is the privatisation of care homes. If they had stayed in the public sector and all care homes were in the public sector, there would not be a problem. The second is means-testing funding. If all funding were public, without means-testing, there would not be a problem. I urge the Government to reconsider the recommendations of the royal commission on long term care for the elderly that all care home residents should be publicly funded out of taxationprogressive taxation at that. There would be no problem with coverage by the Human Rights Act if the Government ensured that all residents of care homes were publicly funded. When the royal commission produced its recommendations, it estimated the cost to the Exchequer at 1 billion a year. That is not much money in the great scheme of thingsit is the equivalent of one third of a penny on the standard rate. I have spoken to many people, in meetings and privately, and asked whether anyone would object to the equivalent of a third of a penny extra taxation to pay for long-term care for everyone, including us. Many of us, because we will live longer and are much healthier than we were, will probably finish up in care towards the end of our lives. Indeed, some people might even choose to enter long-term residential care, which should also be an option, rather than having to enter it because of ill health or infirmity. If we could all be assured that, whatever happened, we would be guaranteed long-term care at the end of our lives that was properly funded by the state, we would all be greatly relieved. Indeed, I have heard no one object to that proposition in all my conversations.
	The other issue is the privatisation of care homes. Personally, I was deeply opposed to the privatisation of care homes and opposed the effective privatisation of care in my constituency, encountering some difficulties with the local authority at the time. Nevertheless, the changes went ahead, under pressure from the Government and through the use of legislative and financial means to press the authority to move care into the private sector. In effect, that is how things happenedthere are still some public care homes, but as the hon. Member for Romsey (Sandra Gidley), speaking for the Liberal Democrats, pointed out, 90 per cent. of care is now in the voluntary and private sectors. That is a matter of concern.
	I believe profoundly in the public service ethosthe idea that when people work in care, they do so not for profit, but to care for their fellow human beings, out of a commitment to their interests. If care is in the public sector, that is indeed what happens. One of the care homes in my constituency that closed down was in the middle of a large community from which people went into residential care. The home was staffed by people from that community who were long-term workers there and was democratically accountable to the local authority. That was the ideal situation, yet the home was closed and the care moved into the private sector.
	I know that we are not talking about bringing all care back into the public sector at this stage, although there is a mood of nationalisation abroad today that I welcome very much. In the longer term, I hope that the Government will look to public ownership once again and make long-term care part of the overall health provision envisaged by everyone from Nye Bevan onwards, based on the principle of universality so well expressed by Beveridge, Bevan and many other socialists of that time, but perhaps put most brilliantly by Professor Richard Titmuss, who influenced me in my youth in setting out the case for universal provision.
	I have made my point. I hope that the Government will consider the possibility of providing free long-term care, which would overcome the problem, and, in the longer term, bringing all care back into the public health service.

Stephen O'Brien: It is always a pleasure to follow the hon. Member for Luton, North (Kelvin Hopkins). Nobody can doubt the sincerity and consistency with which he has presented his arguments both on the Bill and over many years, encompassing human rights and his views on the nature of ownership and delivery. I salute him for the consistency of his arguments.
	I do not intend to take up too much of the House's time. I pay tribute to the work of the hon. Member for Hendon (Mr. Dismore) and the Joint Committee on Human Rights, both in championing the rights of those in care generally and in keeping the Government's feet to the fire on the issue. The Public Bill Committee drew on the JCHR's work, particularly its 18th report of the previous Session entitled The Human Rights of Older People in Healthcare, HC 378. It is important to note that although the Committee was most exercised by the eviction of individuals from care homes, the Government are presiding over a wide range of human rights failings in our health and social care sectors.
	The Joint Committee report noted that
	many witnesses, including the inspectorates, providers and organisations supporting older people, expressed concern about continuing poor treatment of older people in healthcare.
	The report charted failings under articles 2, 3, 8 and 14 of the European convention on human rights in respect of, among other things: malnutrition and dehydration, which we shall expand on in the next group of amendments; inadequate assessment of a person's needs; abuse, neglect and bullying; lack of privacy in mixed-sex wards, which, as it happens, relates to another of the Government's broken commitments; a lack of dignity, especially for personal care needs; too hasty discharges from hospital; fear of making complaints, an issue that unfortunately has not been selected for debate on Report, despite our best attempts; and age, disability and racial discrimination.
	On the basis that it is appropriate to the debate, I should like the House to note the importance of the fear of making complaints in relation to the legislation that we are debating today. This is a cross-party concern. It was raised in Committee by us and by the spokespersons for the Liberal Democrats, as well as by the hon. Member for Luton, North, who said:
	A number of my hon. Friends, not necessarily members of the Committee, are concerned about changes in patient representation and procedures for patients making complaints in recent years. [Official Report, Health and Social Care Public Bill Committee, 17 January 2008; c. 346.]
	The hon. Member for Tamworth (Mr. Jenkins), who I see in his place today, also sought to hold the Government to account for their shortcomings in this area. Furthermore, the hon. Members for Oxford, West and Abingdon (Dr. Harris) and for Hendon are seeking clarification on this issue.
	The remaining unanswered questions on complaints centre on three issues. The first involves resourcing the ombudsman, who is facing an elevenfold increase in work load, yet none of the costs of that increase have been reflected in the impact assessments for the Bill. The second involves monitoring trends. With the Healthcare Commission losing its complaints function, how can we be sure that the early warning signals will be picked up by the regulator? I dare say that we all remember the tremendous work of the community health councils, which were able to use the collective wisdom of all that they had been able to achieve through their inspections and access to hospitals through programmes such as Bedwatch. We discussed that at length when the Government announced that they were axing the community health councils but then had to postpone their abolition and give them a stay of execution for a year. Those functions now appear to be at risk again. I hope that the Minister will address that point specifically.
	The third issue involves putting in place a complaints system for privately funded social care. That has just been referred to by the hon. Member for Luton, North. The Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis), has said in Westminster Hall that
	it is unacceptable that self-funders should not have the protection that other residents have.[ Official Report, Westminster Hall, 11 December 2007; Vol. 469, c. 52WH.]
	He also told the File on Four programme in September that he would be achieving his aim through this Bill. That is all on record. That is a promise, however, that the Government now appear to have reneged on. I hope that the Minister will take note that his colleague has put that intention on the record, and I hope that the Minister has now been persuaded that this is the moment to look at this matter.
	In its submission to the Committee, the Commission for Social Care Inspection said that the new regulator should take a strong rights based approach. In support of that, the Joint Committee said that the Care Quality Commission should adopt a
	human rights framework with the intention that the framework informs all of the inspectorate's work and so makes it more effective in fulfilling its statutory duties.
	The Mental Health Act Commission, which was rightly commended by the Joint Committee for its human rights approach, was particularly concerned in its oral evidence to the Committee that the human rights focus would be lost in the merger. The Government have as yet failed to guarantee that that will not happen. The Commission has called for an overarching principle of equality and human rights, focusing at all times on the civil, legal and human rights of patients.
	In Committee, the Minister confirmed that the frequency of visitsa vital pointwould be
	a matter entirely for the new commission. [Official Report, Health and Social Care Public Bill Committee, 17 January 2008; c. 323.]
	The MHAC, however, wants visits to continue with their current six-month regularity. The choice will be truly free only if the commission is properly resourced to do what it deems important, but the Minister has not as yet given such a guarantee. I hope that we shall be thrilled today by his contribution in that regard.
	It is disappointing that we have to have these discussions on amendments to a Bill on Report. We looked at these matters extensively in Committee, as the hon. Member for Luton, North has mentioned. He was supported in Committee by the hon. Member for Tamworth. They both raised a number of these issues, but it was felt by the Minister that campaigners on this issue would be pleased to hear his commitment that the Government were
	committed to ensuring that independent sector care homes are covered by the Human Rights Act. [Official Report, Health and Social Care Public Bill Committee, 10 January 2008; c. 135.]
	He reiterated the Government's line that that would be achieved in the Bill of Rights, but if he has committed to that, we question why he is not prepared to pass the amendments now.
	Clearly, a cart and horse situation has developed in the Government's mindthat the Bill of Rights is necessary for proper scrutiny in order to arrive at what would be relevant to the application of such human rights to private sector care homes within a Bill of Rights framework. It seems to us that the right place for a thorough going over of that was in Committee, but that was rejected during the course of our deliberations. It is in Committee, Madam Deputy Speaker, that it is appropriate to go through really intense and detailed scrutiny of these provisions, which provide complex material to interweave and interleave into existing legislation. Having an appropriate debate on these amendments now depended on having a proper Committee stage as a matter of principle. In the absence of any such debate and of the bringing forward of the Bill of Rights in advance, our present debate becomes difficult and it is not easy to form a clear opinion of how the provisions will work.
	I notice that a letter in  The Guardian today was signed by 33 different national voluntary sector providers of social care services to disabled people and many others, including all in receipt of social care. They state that the Health and Social Care Bill really must put users at the heart of regulation and argue for the rights-based approach, which was very much the evidence revealed by Dame Denise Platt, the head of the Commission for Social Care Inspection, during Committee hearings.
	If the new clauses and amendments are pressed to a Division, it would be difficult for us to signal our support, but at the same time we do not intend to vote against them either. We want to register our main point that the Bill of Rights that the Government have prayed in aid absolutely needs to be brought forward fast; otherwise, the Government's commitments will be revealed as hollow. Clearly, there is a major demand to involve human rights principles, not least those articulated by the Joint Committee, but in the absence of discussion of the Bill of Rights, we are in grave danger of trying to legislate for the cart before the horse has been debated. On that basis, our position is clear.

Ben Bradshaw: As has already been said, this group of amendments deals with a number of matters raised in the legislative scrutiny report of the Joint Committee on Human Rights, which was published earlier this month. It has provided a very helpful human rights perspective to the Bill and I would like to take this opportunity to pay tribute to the Committee's diligent and important work under the chairmanship of my hon. Friend the Member for Hendon (Mr. Dismore). Indeed, I pay tribute to all hon. Members who contributed on the issue of human rights as the Bill went through Committee.
	I hope to offer some words of comfort to my hon. Friend and to them, but I also need to say from the outset that we do not believe that most of the amendments in the group are necessary. I shall come on to explain why in a few moments. We agree with the principle behind the Joint Committee's proposed amendments, but we do not see the need to inscribe everything in primary legislation. I understand that proposing a large number of amendments in this way represents a new approach for the Joint Committee, but in this instance I am not sure that it is the most effective way to proceed. Where the Government are giving undertakings or are already pursuing a particular policy, I hope that the Committee will accept those undertakings rather than pursue the course of specifying every last detail directly in the legislation.
	New clause 1 is designed to apply the Human Rights Act 1998 to all public and all independent providers of health and adult social care registered with the new Care Quality Commission if the care is publicly funded either wholly or in part and is pursuant to statutory powers. We heard a great deal in the evidence presented to the Committee and in the Committee's own deliberations about the case for bringing private and voluntary sector health and social care providers within the scope of the Human Rights Act 1998. I said, and I repeat, that I am sympathetic to the intention of dealing with publicly funded care, be it health or adult social care, that is behind the new clause. I thank my hon. Friend and his Committee for setting out the issues so clearly. As I hope I made clear in Committee in response to a number of proposed amendments, including those tabled by my hon. Friend the Member for Luton, North (Kelvin Hopkins), the Government are firmly committed to amending the Human Rights Act to ensure that all publicly arranged care provided by the independent sector is covered by it. We have agreed with the Ministry of Justice that it would be appropriate to use the Health and Social Care Bill to strengthen regulatory powers to ensure that the Care Quality Commission can enforce regulatory requirements in line with the spirit of the European convention on human rights.
	However, as I indicated, we have difficulties with new clause 1 as drafted. For example, it links the coverage of the Human Rights Act to regulated activity, as defined in clause 4, which would be registered with the Care Quality Commission. That merely provides for regulations to determine what is a regulated activity. Therefore, the scope of the Human Rights Act could be altered by secondary legislation. I am sure that that is not the intention of my hon. Friend the Member for Hendon. I suspect that the relevant Committee in another place would consider it an inappropriate delegation of powers for an Act as important as the Human Rights Act. Moreover, we are also not sure what would or would not be covered by the test within the new clause of care provided
	wholly or partly at public expense.
	Would that cover all residents in a care home where one out of 50 was funded by a local authority? Would it apply to everyone receiving care provided by a charity that received a very small annual grant?
	However, as I said, I am sympathetic to the intention behind the amendment and the concerns expressed by evidence givers and by members of the Public Bill Committee and the JCHR. I undertake to consider the issue of publicly arranged health and adult social care and the Human Rights Act in the context of this Bill, with a view to the Government reporting back on that important issue during its passage in the other place. I hope that that offers some reassurance to my hon. Friend that the Government are continuing to consider the issue. In the light of that, I hope that he agrees to withdraw the motion.
	Amendments Nos. 3 and 4 would place a duty on the Secretary of State to ensure that regulations under clause 16 include provision intended to secure the rights of those receiving services in addition to their health, safety and welfare. We must be careful not to create an expectation that the new Care Quality Commission will be a quasi-judicial or ombudsman-type body, as the amendments would do. Regulations under clause 16 will set out specific requirements that will be in line with the spirit of the European convention on human rights, but are relevant to the provision of health and social care services. It will be by enforcing those specific requirements on health and social care provision that the commission will support the promotion of human rights.
	New clause 2 and amendments Nos. 5, 6 and 7 would require the protection and promotion of human rights to be central to the work of the commission. We had quite a lot of discussion about that in Committee, not least in response to the amendment tabled by my hon. Friend the Member for Luton, North. I confirmed that as a public body, the commission will of course be subject to the Human Rights Act and will have to carry out its functions in ways that are compatible with it. In carrying out its work in checking that providers comply with the registration requirements, the commission will be able to ensure that providers follow the spirit of the European convention on human rights.
	We are keen to get the registration requirements right. Rather than this being a tick-box exercise, to quote my hon. Friend the Member for Hendon, the commission's work in ensuring compliance will be a real driver to help to achieve the wholesale cultural change that the JCHR's report seeks. I also encourage all those with an interest in the safety and quality of health and adult social care services to participate in the forthcoming consultation on those registration requirements. That is an open invitation to him and his Committee to do so.
	Amendment No. 8 would require the commission to perform its functions in a way that encourages health and social care services to improve the information that they provide to patients and service users about their rights. We agree that it is important that people have information on their rights and entitlements so that they can make informed decisions about their care and treatment, but the amendment is not necessary to achieve that. The Government have already distributed guidance and a toolkit on human rights and health care to the NHS, and that is available to the public. The Human Rights Act makes it unlawful for the Care Quality Commission, or any NHS body or local authority, as public authorities, to act in a way that is incompatible with the convention right. It is therefore for the courts to ensure that they comply. Of course, other bodies, such as the Equality and Human Rights Commission, have a leading role in that.
	Amendment No 11 would require the commission to have specific regard to whether adequate advocacy services are available when carrying out its functions. The Government recognise the importance of good advocacy services. Section 12 of the Health and Social Care Act 2001 gives the Secretary of State for Health a duty to arrange the provision of independent advocacy services for those who make complaints about the NHS, and we established the Independent Complaints Advocacy Service to support patients and members of the public wishing to complain about their NHS care or treatment. In the context of social care, we intend to provide equal access to advocacy alongside the new complaints arrangements. We are still examining the details of how that can best be achieved.
	While the commission will encourage the provision of good advocacy services through its review functions and by monitoring the adequacy of complaints processes operated by service providers, we do not consider that that should be central to its role. It would therefore be inappropriate for us to include it in the list of the matters to which it must have regard as a matter of course when carrying out its functions.
	New clause 4 is linked to clause 41, which enables the Secretary of State to publish statements of standards relating to health care provided and commissioned by primary care trusts. The standards will provide a practical set of benchmarks for different services. The new clause sets out a number of topics to be covered by standards under clause 41, relating to the rights of patients and service users. We intend to hold wide-ranging discussions and full consultation with patients and clinicians on the details of the standards, because we want to ensure that they deliver real improvements in care. We feel that it would be inappropriate to set out the details in the Bill in advance of that consultation; indeed, I am not convinced that such standards should be in primary legislation at all, as it will be necessary to refine them frequently.
	My hon. Friend the Member for Stoke-on-Trent, North (Joan Walley) expressed concern about publicly commissioned services provided by private non-urgent ambulance services. I invite her to make the case that she has made today during the consultation on the registration requirements, but I can reassure her that any publicly provided health or social care service will fall within the scope of the Bill, in terms of both human rights and registration requirements.

Kelvin Hopkins: May I reinforce a point about the training and education of staff? On Second Reading, I raised concerns that had been put to me by Unison and the Royal College of Nursing. They wanted to make absolutely certain that the quality of staff was good across the board, and that there was no danger of a two-tier service developing in time.

Ben Bradshaw: I am about to deal with amendments Nos. 14 to 18, which refer to professional qualifications and training. I hope that this will reassure my hon. Friend. The amendments are intended to implement the recommendation of the JCHR about professional regulation, which suggested that
	basic principles such as dignity, fairness, respect and equality be included in qualifications, accreditation and re-licensing for health professionals.
	We do not consider the amendments to be either necessary or appropriate to achieve the objective that I think we all share. They seek to impose various duties on the Council for Healthcare Regulatory Excellence, the Office of the Health Professions Adjudicator and the General Social Care Council. Each of those bodies is a public authority, and as such they must already carry out their functions in a manner that is compatible with the European convention on human rights. We therefore see no need to impose specific duties on them, and do not consider that any benefit would be gained from our doing so.
	I trust that my assurance that the Government will examine the issue of publicly arranged health and social care provision and the Human Rights Act again in the context of the Bill will enable my hon. Friend the Member for Hendon to withdraw new clause 1, and I hope that I have persuaded him that his other amendments are not necessary either.

Andrew Dismore: I hope that my hon. Friend does not take exception to the fact that our Committee proposed amendments. We see that as an extension of our general scrutiny role, particularly if the Government do not accept the recommendations in our reports. In that event, inevitably, our only alternative is to bring them to the Floor of the House by tabling amendments, and we may do that rather more frequently in the future, not just in relation to my hon. Friend's Department, but more generally.
	The debate we had on the YL case emphasises the importance of the comprehensive approach that my Committee advocated from an early stage, as exemplified by a private Member's Bill of mine in the last Session and another Bill of mine in this Session. All the questions and criticisms that have been raised would have been dealt with by such an approach. The question of devolution, which the hon. Member for Romsey (Sandra Gidley) raised, could be dealt with by a comprehensive approach in a dedicated Bill. The question of patient transport services, as addressed in amendments to the Bill, could also be dealt with. My hon. Friend the Member for Luton, North (Kelvin Hopkins) raised issues to do with self-funders, and they could also be dealt with. I am not entirely sure that I agree with him on that point, however, because even if there was no means-testing, the people concerned would still be in a private sector home, so without things being resolved in accordance with the YL case problems would still arise.
	My hon. Friend the Member for Luton, North also raised more general issues that stray into the wider Bill of Rights debate. Those of us who are involved in the human rights world come across three major issues. One is horizontality, which I mentioned earlierapplicability between private individuals and companies. His comments strayed into that area, and also into the second big issue: social and economic rights. However, he kept off the third one: third generation rights, which are to do with environmental issues.

Kelvin Hopkins: rose

Andrew Dismore: My hon. Friend might be about to add to the list.

Kelvin Hopkins: Just to clarify, I understand that the Government are looking at the possibility of publicly funded residents in private care homes of covered if there was no means-testing, so that everyone is publicly funded and everyone, by definition, is covered.

Andrew Dismore: I hear what my hon. Friend says, but it is important to get back to where we started before we start to develop our ideas. I have a lot of sympathy with his points, but we must resolve the immediate problem first.
	I am pleased that my hon. Friend the Minister has recognised the importance of this matter and that it will be returned to in the other place. I am not entirely sure that he is with us, however, when he talks about looking only at the regulatory powers aspect. Does he therefore exclude the general application of the Human Rights Act 1998 to care home residents, including, for example, their power to take matters to judicial review, as in the YL case and the Leonard Cheshire homes court case? Those cases were brought by individuals who were affected; they enforced their own rights and were not reliant on the commission or another agency to help them do so. I hope that when the Government table an amendment in the other place, it will address the fundamental problem of the definition of what is a public authority in this context, as one of my amendments would do. On that basis, I would be happy not to press this particular matter any further.
	On wider issues, the hon. Member for Eddisbury (Mr. O'Brien) raised the important need for a rights-based approach. That is fundamental to the second batch of amendments, if I can use that general term to describe the amendments that are all variations on that theme.
	I am concerned that my hon. Friend the Minister says we are raising expectations, because the expectations in question relate to people's rights that already exist. That takes us back to a point I made earlier: the Government say that they expect certain things to be done, but the rights already exist in law and should be enforced. I am therefore concerned that he feels that they should not be included in the Bill, in the context of a rights-based approach. It is said that the matter will fall under the commission's general responsibilities, and that it will conduct enforcement and inspections in the spirit of the Human Rights Act, but if that fundamental principle is not included in the Bill in some way, shape or form, the importance of that rights-based approach will be underplayed. All the evidence that we have received supports that argumentas, I think, does the evidence the Public Bill Committee received.
	In the spirit of compromise, I do not propose to call for a vote. My hon. Friend has said that these issues can be looked at again in the other place. As he knows, one advantage of the Joint Committee on Human Rights is that we have members from both Houses, so we can keep each other well briefed and informed. If my hon. Friend does not table amendments, particularly on the rights-based approach, I will be very surprised if my Committee colleagues in the other place do not do the job for him again, so that we end up having this debate again, perhaps even on Lords amendments back in this House.
	We have had sweetness and light so far today, and I would give the Government a mark of seven out of 10. On that basis, I beg to ask leave to withdraw the motion.
	 Motion and clause, by leave, withdrawn.

New Clause 15
	  
	Code of practice relating to malnutrition

'(1) The Secretary of State may issue a code of practice about compliance with any requirements of regulations under section 16 which relate to the prevention or management of malnutrition.
	(2) The code may
	(a) operate by reference to provisions of other documents specified in it (whether published by the Secretary of State or otherwise);
	(b) provide for any reference in it to such a document to take effect as a reference to that document as revised from time to time;
	(c) make different provision for different cases or circumstances.
	(3) The Secretary of State must keep the code under review and may from time to time
	(a) revise the whole or any part of the code, and
	(b) issue a revised code. [Mr. Stephen O' Brien.]
	 Brought up, and read the First time.

Stephen O'Brien: I beg to move, That the clause be read a Second time.

Madam Deputy Speaker: With this it will be convenient to discuss amendment No. 105, in clause 16, page 8, line 31, at end insert
	'(7A) Regulations made under this section may make provision for the prevention and management of malnutrition and may include such provision as the Secretary of State considers appropriate for the purpose of safeguarding individuals (whether receiving health or social care or otherwise) from the risk, or any increased risk, of malnutrition.'.

Stephen O'Brien: Amendment No. 105 is intended to establish regulations to deal with malnutrition. It is drafted in the same terms as clause 16(5), which is on health care-acquired infectionsor health care-associated infections, depending on which of the Government's definitions one chooses to take. New clause 15 would provide for a code of practice on malnutrition and is drafted in the same terms as clause 17, which provides for a code of practice relating to health care-acquired infections.
	The context of the new clause and amendment is necessarily fixed within the area of health care-acquired infection. The Government have put in the Bill the need for regulations about health care-associated infections, as they call them, notably methicillin-resistant Staphylococcus aureus and clostridium difficile, and a code of practice on preventing them. While that is laudable, I fear that it will do little to dent the Government's ongoing failure on health care-associated infections unless proper infection control measures are put in place in the code.
	Although health care-associated infections are falling, the rate is still way off track to meet the Government's 2004 target of halving MRSA rates by March 2008. The Secretary of State for Health has contradicted the Prime Minister's promise of screening for C. difficile; bed occupancy is up; deep cleaning is a gimmick with no new money attached; there is no decent search-and-destroy strategy; and Government promises on isolation wards are still being broken. I am sure, moreover, that the House was pretty disgusted by the Health Secretary's posturing promise that he would prevent a payout to the chief executive of Maidstone and Tunbridge Wells NHS Trust, considering that, on 24 Januaryjust a few days agowe discovered not only that the Secretary of State never had the power to do that, but that the chief executive received 75,000 of taxpayers' money for her failure. That is the context in which malnutrition is so important.
	As we know, according to the Government's own figures in Clean, safe care: reducing infections and saving lives, published on 8 January, MRSA affected about 6,000 people in 2006-07 and C. difficile about 56,000. By contrast, in 2006-07 no fewer than 139,127 patients were discharged from hospital in a state of malnourishment. The issue is not just about malnourishment; it is also a human rightswe have just discussed human rightsissue. The Joint Committee on Human Rights, in its recent report, The Human Rights of Older People in Healthcare, noted that malnutrition and dehydration in care settings breached articles 2, 3 and 8 of the European convention on human rights. Figures cited in the Department of Health's own nutrition action plan show that the cost of under-nutrition is estimated at 7.3 billion a year, and a recent  British Medical Journal study reported that about 20 per cent. of patients in hospitalone in fiveare malnourished.
	Despite those figures, which reaffirm those provided through BAPEN's screening weekI assume that everybody in the Chamber knows that BAPEN is the British Association for Parenteral and Enteral Nutritionan initiative that the Minister claimed to support, the Department chose to rubbish them as
	hopelessly out of date or misinterpreted.
	Furthermore, the Government's own figures, provided to me through written parliamentary answers, show that the number of undernourished patients being discharged from hospital has risen by 84 per cent. since 1997. There is little evidence that the Government have either the will or the conviction to tackle the problem. Since the new year, they have failed to take the opportunities afforded by the publication of vital signs indicators for primary care trusts, of responses to the payment by results consultation, and of the Bill to demonstrate their intention to do so. Of the 83 vital signs targets, none relates to malnutrition. It has been pointed out to the Department that the lack of recognition of support services, such as those on nutrition, in PBR acts as a barrier to the commissioning of effective care pathways.
	Most damning was the voting down in Committee of an amendment that would have put the importance of tackling under-nutrition on the same statutory footing as tackling hospital-acquired infections. Clearly, therefore, the Government see under-nutrition as a peripheral rather than central issue in respect of both health and social care and human rights. The new clause and amendment give the House an opportunity to make a genuine addition and improvement.
	Given the Government's repeated refusal to make use of opportunities to tackle under-nutrition, such as in the NHS's operational plans and the system of PBR, my view and that of my colleagues is that we simply cannot accept the Minister's feeble assurancefeeble is a strong word, but it is correct in this contextto the Committee that he hoped that malnutrition would be included in the core registration requirements examined by the new Care Quality Commission. He said no more than that he hoped that that would happen. That seems a wholly insufficient and inadequate response to what is patently a major issue, given evidence that was based wholly on the Government's own information and statistics, and which was published in parliamentary answers. Unless we hear from the Minister an important and new voice on the matter, it will be important for us to register our concern. We shall want to pursue the matter at this stage and certainly as the Bill proceeds to another place. When it does, I hope that this time the Government will support such amendments.

Sandra Gidley: I am pleased that we have a chance to debate this subject. I can understand the irritation of the hon. Member for Eddisbury (Mr. O'Brien) at being denied an opportunity to discuss health care-acquired infection again. Although we did not support some of his amendments in Committee, it was their style, rather than the thought behind them, that was problematic. However, he has used this opportunity to raise an important subject.
	The hon. Gentleman mentioned BAPEN, whose survey last November concluded that more than one in four adults admitted for stays in hospitals, mental units or care homes is at risk of malnutrition. He said that the Government have rubbished those figures, but the Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis), who has responsibility for care services, said:
	BAPEN's research has provided us with consistent information on the scale of malnutrition in the community for the first time. This work highlights the fact that on being admitted to a hospital or a care home it is important that every older person is given a nutritional screening which is reviewed on a regular basis.
	That point relates not just to older people. It appears that there is some division on the matter. I see that there is to be a nutrition action plan, but I can find little by way of an update on it since the announcement that it was being set up. I am not clear whether those involved have even met yet.
	I was struck by an article called Behind the Medical Headlines by Dr. McKinlay, who is a consultant gastroenterologist at Aberdeen Royal infirmary. I do not think that malnutrition is any different a problem in Scotland; in fact, BAPEN said that it was fairly consistent across the four nations. The article was even more damning. It was based on a survey of prospective in-patients at a Dundee hospital and it said that more than 40 per cent. of acute admission patients are undernourished and 75 per cent. of patients lose weight during their hospital admission. That is a worrying statistic. The article goes on to discuss some of the reasons for that and we must also bear in mind that patients are not moving around and burning off energy.

Stephen O'Brien: The hon. Lady highlights one of the points that has caused me the greatest anxiety. Since 1997, more people going into hospital are malnourished, either because is their usual state or because it is part of their illness. Not only do more people come out more malnourished or undernourished than when they went in, but the numbers of those who go in malnourished have grown compared with 10 years ago. The incidence of malnourishment as a phenomenon has increased over that period, which is why it is so crucial that the issue is added to the Bill. That would send a message from this place and put the issue on a par with health care-acquired infections.

Sandra Gidley: The hon. Gentleman is right. The figures are set against an average decrease in the length of stay in hospital, so one wonders what is going on.
	In 2005, BAPEN published an economic analysis of the cost of disease-related malnutrition in the UK. The total cost was estimated to be 7.3 billion, with approximately 3.8 billion incurred in hospital and 2.8 billion in long-term facilities. I would have assumed that the Government were keen to address that avoidable cost by putting in place some simple measures. We have all seen the programmes with undercover filming in geriatric wards and nursing homes, in which people are not helped to eat or given inappropriate food. Tackling the problem, and ensuring that there is a clear code of behaviour, would also address some of the human rights aspects of the issue. As the hon. Gentleman rightly pointed out, this is a human rights issue, because many elderly people are not getting the care and attention they deserve, however many dignity strategies the Government introduce.
	The conclusion of the article to which I was referring states:
	In the majority of inpatients, however, the most important single factor leading to malnutrition is probably loss of appetite and failure of intake.
	If someone is unable to eat for any reason, there are things that can be done to minimise the results. There is little detail behind the amendments, but they are well intentioned. I hope that they will find some favour with the Government, because the problem is real and avoidable. There are no targets to address it and it is too often overlooked.

Kelvin Hopkins: I wish to contribute briefly to this debate. Traces of minerals and vitamins have been shown, even in the last week, to be of crucial importance in the onset and development of Alzheimer's and of dementia in general. I urge the Minister to pursue that research because it could make a tremendous difference not only to the lives of millions of people who might not develop dementia if they have the right diet and vitamin and mineral intake, but to those who already have the disease, because it could be prevented from developing further.

Stephen O'Brien: We need to be careful not to let the market get ahead of us, because we should be trying to lead on this issue, not follow. Interestingly, the sale of aluminium kettles and pans has collapsed since the suggestion that aluminium deposits in boiled water could contribute to the development of dementia.

Kelvin Hopkins: We are certainly well aware of the problem with aluminium, but some vitamins and trace elements are positive in their effects. I want to be sure that the Government are aware of the most up-to-date research and promote the use of those vitamins and minerals by those who are healthy as well as by those who are already in care, not only for the welfare of people in generalabout which we are all concernedbut for the sake of public expenditure. If fewer people become ill or can be kept healthier when in care, there will be a saving to the public exchequer

Sandra Gidley: Is the hon. Gentleman aware that research has shown that if the level of nutrition is generally higher, it reduces GPs' workload? If we send people out of hospital in a better state of nutrition, it will reduce the GP bill.

Kelvin Hopkins: I am sure that we would all agree that it would be beneficial all round. Specifically, it would be beneficial to the public purse, as well as to the general wellbeing of the population. I urge my hon. Friend the Minister to do what he can to pursue the most modern research and promote good nutrition in the healthy, as well as in those who are already in care.

Angela Browning: I am pleased to support the amendments as I spoke on the issue in Committee and I have raised it in the House in the past. The Government must take this opportunity.
	A code of practice should ensure that people who are sick and who have been admitted to hospital are given a good, nutritionally balanced diet, but it should also go further. It should require that a patient's particular medical condition is taken into account when balancing their nutrition. If people have suffered serious bone damage, it is important that they get certain vitamins and minerals, such as calcium phosphorus and vitamin D, to enable the growth of new bone. Of course, those vitamins and minerals are also important for healthy people, to try to offset osteoporosis and other problems.
	The hon. Member for Luton, North (Kelvin Hopkins) mentioned dementia, and we now know that certain vitamin and mineral deficiencies cause behavioural symptoms that are often misdiagnosed. It is important that a professional takes a close interest in how patients are eating and behaving, as well as in their physical condition. I do not suggest that we want the professionals to have to tick lots of boxes on a piece of paper, because it could become so bureaucratic as to lose its purpose, but I hope that the Minister will be receptive to the firm plea from both sides of the House that a code of practice is included in the Bill.
	The issue is not just the food, or even just the quantity, although it is important to monitor significant weight loss in people in residential and nursing homes or in-patients. That can tell a professional that something serious is going on. Also, particularly with elderly people, it is important to ensure that the code of practice identifies what we expect of the home or the hospital in assisting people, who might otherwise be unable to accept what is on the menu, to eat. Of course, that will start to involve assistance with eating and, as we all appreciate, that involves staff time, which is often rare in hospital wards.
	In Committee, I mentioned the difficulty of dealing with elderly people in trauma wards who often cannot hold their knife and fork, or even a spoon, and who need somebody to sit with them and help them eat. If the Minister is prepared to be helpful on this point, I hope that the code of practice will consider not only the food and nutrients but what is done to assist people in getting that intake of food. Sometimes, such help is about listening and observing more than anything else.
	In my experience of having elderly relatives in hospital, some at the end of their lives, when I have seen best practiceand I haveit has been extremely good. I am thinking particularly about my mother during her last weeks in the excellent Wokingham hospital. As she was unable to take solids, her food was mashed and later pureed. A lot of thought went into what consistency the food should be that she would be able to eat. In contrast, other relatives in other hospitals did not have that experience. It was extremely distressing. As a familyin this countrywe felt that we had to work a rota to ensure that elderly, frail relatives were fed at mealtimes in hospital.

Stephen O'Brien: My hon. Friend is giving moving evidence, which is an accurate observation that has, I am sure, been shared by many here and outside this place. She will be the first to accept that however important it is for family members, when they exist, to take part in a rota, an adjustment is needed in the expectations placed on nurses. They ought to be given the time to do the difficult task of getting the appropriate types of food into the mouths of those who are most vulnerable and unable to help themselves, and that use of their time should be valued. At the moment, many of the other targets drive nurses away from feeling that they have the time to do that.

Angela Browning: That is obviously right. Families who have a loved one in hospital or sick want to do their best for them. I am not saying for one moment that relatives do not want to help, willingly, at mealtimes and other such times. However, there is a difference between the relative who sits by the bed and helps to deliver the meal to the patient and the family who feel that they have to be there at lunchtime and in the evening just to ensure that the patients gets some food. There is a fear that if families do not organise that themselves, the patient will slip through the net. We should not accept that in this country in this day and age.
	This is an important opportunity. As MPs, we have to deal with such casework from time to time and it is distressing to have to deal with cases that involve people who have not received help and support on nutrition and feeding, particularly when they become frail and vulnerable. As we get an older population, more people do not have any close friends or relatives. In those cases, it is important that the residential care home, the nursing home or the hospital ward not only protects people's human rights but has a code of conduct that is in force and inspected to ensure that such cases occur fewer times, not more. The trend is going the wrong way. The Minister is a compassionate man. If he wants to show that compassion during any part of the Bill, now is the time.

Brian Jenkins: As my hon. Friend the Minister knows, I was not going to speak on the Bill. However, alarm bells are ringing in my head as I sit here and listen to people's speeches. I know that they speak with the best intentions, but clause 16(3)(b) clearly states that regulations may
	make provision as to the manner in which a regulated activity is carried on.
	We are discussing encompassing in that a regulator who will look after people and make provisions on how activity is conducted. I had grave doubts about telling people, You must stop infecting people as they enter your hospital. I do not think that any hospital intends to infect people. I do not want to tell doctors and nurses to wash their hands between going from patient to patient. That is a difficulty. If we are now to start telling the people who are running our health service, You must start feeding patients, something is dramatically wrong. If we are to start telling residential homes that they must start feeding their clients, that is wrong.
	If we list 24 different items that are included, when number 25 comes up we will be unable to blame the bodies, because they will say, It wasn't on your list of 24, Minister. Surely, we are providing a general duty. If the Minister is going to add more to the Bill, he should be careful. Anything left off will be deemed unimportant because of its omission. I acknowledge every sentiment about the problem of malnutrition in our hospitals and residential homes, but I ask the Minister, please, to be careful before he starts telling those organisations what meals they need to have and what vitamins they should put in their food. I felt that concern as I heard the debate; the Minister should be wary of going down that path.

Ben Bradshaw: We enjoyed a long and detailed debate on this issue in Committee. As I said then, I have a great deal of sympathy with the motives behind the amendments, but there are good reasons why they are unnecessary. As most hon. Members have recognised, we are making significant progress. We have been working closely with the Food Standards Agency to improve the nutritional quality of hospital meals. We have launched the better hospital food programme, which is having an impact. The patient environment action team assessments show that there has been an increase from 17 per cent. of food being described as good in 2002 to 44 per cent. being rated excellent in 2006-07.
	We also recognise that older people in hospital are particularly vulnerable to malnutrition. To identify and deal with that risk, we have introduced protected meal times. We are putting particular emphasis on the screening that has been advocated by a number of hon. Members in this afternoon's debate. Those two areas of work are being pursued by the National Patient Safety Agency.
	The Royal College of Nursing has recently signalled its commitment to addressing the issue and has launched its nutrition now campaign, which aims to help all nurses at all levels to improve the nutrition and hydration of patients. The Nursing and Midwifery Council, the regulatory body for nurses, has identified nutrition as one of the core skill areas to be singled out for special assessment of competence before nurses are admitted to the register, a move that we warmly welcome.
	As I mentioned in Committee, last October the Under-Secretary of State for Health, my hon. Friend the Member for Bury, South (Mr. Lewis), launched a nutrition action plan to build further on that work. The plan is being developed with leading stakeholders. Indeed, Opposition Members referred to the Age Concern report, Hungry to be Heard, and they will be pleased to learn that Gordon Lishman, the director of Age Concern who is responsible for pioneering work in the field of nutrition, has agreed to chair the national action plan delivery board.
	I also described in Committee the detailed standards in nutrition that apply to the NHS under the standards for better health and the national minimum standards that apply for registered health and adult social care providers. They are core standard 15a, which states:
	Where food is provided, health care organisations have systems in place to ensure that...patients are provided with a choice and that it is prepared safely and provides a balanced diet.
	Core standard 15b states the need that
	patients' individual nutritional, personal and clinical dietary requirements are met, including any necessary help with feeding and access to food 24 hours a day.
	For assessment against core standard 15, the Healthcare Commission will use the criteria, which were signed off by the Secretary of State for Health in 2007-08, that patients should be offered a choice of food in line with the requirements of a balanced diet, reflecting the needs, preferences and rights, including faith and cultural needs, of the service user population.
	I also went on to describe how the Healthcare Commission's national in-patient survey had shown that 53 per cent. of adults now rated the food that they ate in hospital as good or very good. The better hospital food programme, which was launched in 2001, introduced five key improvements: 24-hour service, NHS snack boxes, additional snacks twice a day, a hot meal in the evening and menus including three dishes created by leading chefs. So an awful lot is happening with food and nutrition, but I accept the points made by hon. Members that more needs to be done.
	In December, we published our annual operating framework, which recognised for the first time the importance of including regard for the patient experience as one of the NHS's five main priorities. If there is one thing that comes up time and again in consultations and when hon. Members talk to their constituents about their experience as patients, the quality of food is very high on the list, as well as issues such as how people are treated by staff and receptionists. It is very important that, by including the issue in the five main priorities that the Government have given to the health service, we will see further improvements. Indeed, I held a meeting last week to find out how we could best spread the really good practice that hon. Members are aware of happening throughout the country. I recently visited Cornwall, where the local hospitals are doing an excellent job in serving, I believe, 80 per cent. of locally bought produce, fresh from local farmers, butchers, dairy farmers and fishermen. That is going down very well with patients there, and it is improving recovery rates.
	I want to deal with the claim made by the hon. Member for Eddisbury (Mr. O'Brien) both here and in Committee about patients allegedly being discharged with malnutrition. He made that claim, both generally and in Committee, in reference to my local excellent hospital. It surprised me, and it also surprised the chief executive of the Royal Devon and Exeter hospital. It might be based on a misunderstanding of the definition of episodes. If he will bear with me, it is important that this is put on the record, as the allegations are quite serious.
	For the purpose of the hospital episode statistics, a patient's stay in hospital is referred to as a spell and each period under the care of one consultant is known as a episode. So a patient who is under the care of several consultants during the spell in hospital has several episodes. Someone under the care of only one consultant throughout the stay has only one episode. For the purpose of the statistics from which the hon. Gentleman draws his allegations, the first episode is known as the patient admission episode and the last episode is known as the discharge episode.
	If someone has only one episode in hospital and if they remain under the care of only one consultant during their stay in hospital, their patient admission episode and their discharge episode would be the same. So someone admitted, for example, for the treatment of a nosebleed would have nosebleed recorded as their admission episode and their discharge episode. That does not mean that they leave hospital with a bleeding nose. Similarly, someone whose final treatment episode is registered as being for malnutrition does not leave hospital with malnutrition, as the hon. Gentleman suggested earlier. They are not discharged with malnutrition.
	There may be a number of reasons why malnutrition, for example, is not picked up when someone is admitted to hospital. It might be part of a more serious condition for which they are being treated or operated on, and it is diagnosed only when they are recovering from the more serious condition for which they are being treated or operated on. That explains why their final treatment episode might be for malnutrition, when their initial treatment was not. Hence the allegation made by the hon. Gentleman that people were becoming malnourished in hospital is not the case. Similarly, it might be that, when recovering from a serious operation, a patients loses their appetite, so their final treatment in hospital is for malnutrition, but that does not mean that they are discharged with malnutrition. So I hope that that helps to clear up that point.

John Gummer: I wonder whether, as part of a continuing campaign, it would be possible for the Minister to refer all this to the people who invented these phrases. In the end, people ought to understand this information. Although elegant in his presentation, the Minister has made it clear that this is pretty difficult for people to understand. If we are to try to follow this properly, can we not speak in English? The word episode does not mean that in any other form. Perhaps the national health service would be kind enough to try to communicate with us more reasonably.

Ben Bradshaw: I absolutely agree with the right hon. Gentleman. As a result of my desire for clarity, I went back after our discussions in Committee to try to shed some light on the issue. I am sorry if I have not managed to do it with more clarity. A better phrase for episode is what one is being treated for during a particular period of one's stay in hospital. As I am trying to say, someone may be treated for a range of different things while they are in hospital. What they are treated for at the end of their stay in hospital might be different from what they were admitted to hospital for. I simply tried to clear up the misunderstanding that has arisen as a result of how the hon. Member for Eddisbury interpreted some answers to parliamentary questions that led him wrongly to suggest that people were being discharged with malnutrition. They are not being discharged with malnutrition.

John Gummer: I very much accept the help that the Minister is giving, but I come back to the point that, if we are to pass on information, the importance of that information and truth is not what leaves the lips but what is heard in the ears. If people cannot understand what is said either in an answer to a question or, more likely, at the heart of the NHS, is it not important that we recast it in such a way that it does not need the Minister's intervention for anyone to understand it?

Ben Bradshaw: The reason why it needed my intervention was the misunderstanding on behalf of the hon. Member for Eddisbury. I hope that, when he reads  Hansard tomorrow, he will see that I have cleared it up; but if I have not, I will write to him in a further attempt to do so.

Stephen O'Brien: I bore with the Minister right the way through to make sure that he said the whole of what he had to read out. I entirely share the concern of my right hon. Friend the Member for Suffolk, Coastal (Mr. Gummer) about the use of English, but that is another matter. I am sure that the Minister will be the first to agree that I have based all these malnutrition arguments and the question of whether it has got worse or better over the past 10 years entirely on Government statistics produced in response to my written parliamentary questions, which were then given ministerial answers. From what the Minister has just said and assuming that we can find a common form of language that we are likely to understand, it seems to me that, if I was to retable those questions, he might undertake to give the answers to me in a way that everyone can understand. If he wants to demonstrate that malnutrition has not got worse in hospital stays in this country over the past 10 years, I hope that his answer will bear that out; but as things stand on the record, I am right and, at the moment, he is wrong.

Ben Bradshaw: Anyone who has fairly followed my record in this place will know that I always try to answer questions succinctly. Perhaps I tried to answer the hon. Gentleman's written questions too succinctly. If I had given a little bit more detail, as I have given the House today, he might not have been led to make the claim that he made in Committee and during this debate.
	The hon. Gentleman asked why we were making separate provision for health care-acquired infections yet not giving nutrition the same level of importance. The separate provision for health care-associated infections is already in existing legislation. We already have the code of conduct that Parliament approved during the introduction of the code of practice as part of the National Health Service Act 2006. That provides a framework on how services can prevent and control health care-associated infections and has been well received in the field. It would not make sense to remove that vital guide for tracking infections. May I take the hon. Gentleman to task for accusing the Government of failing to get infection rates down? He will know that since we were in Committee, we have reported a 40 per cent. decrease in MRSA since 2003-04 and a 16 per cent. decrease in C. diff in the past year alone.
	We do not desire areas such as nutrition to be neglected. Indeed, in everything that I have said about the subject both in the Chamber and in Committee, I have reconfirmed the importance that should be placed on nutrition. We have acknowledged throughout our debates on the Bill that the commission is best placed to set the specific criteria by which providers are assessed for compliance with registration requirements. However, I have said before, and I will say again, that we intend that registration requirements will make reference to nutrition. The Committee was shown examples of how they might look and copies were placed in the Library. Hon. Members will be aware that we will issue consultation on the issue shortly. In that spirit, I invite the hon. Gentleman to withdraw the motion.

Stephen O'Brien: I listened very carefully to the Minister. Interestingly, the hon. Member for Tamworth (Mr. Jenkins) unwittingly put his finger on the fact that although health care-associated infections are mentioned in the Bill, malnutrition is not. He suggested that it would be dangerous to add anything more to the Bill. However, malnutrition affects 137,000 people, whereas 6,000 are affected by MRSA, for example. If we want to demonstrate that addressing malnutrition is of equal importance, we will want a reference to it in the Bill. On that basis, I urge my colleagues to join me in the Lobby in support of new clause 15.

Question put, That the clause be read a Second time:
	 The House divided: Ayes 186, Noes 263.

Question accordingly negatived.

Clause 2
	  
	The Commission's functions

Ben Bradshaw: I beg to move amendment No. 62, page 2, line 10, after 'by', insert 'or on behalf of'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following: Government amendments Nos. 143 and 63 to 65.
	Amendment No. 142, in page 28, line 26, clause 57, at end insert
	'(5) The Secretary of State may, after consulting the Commission, by regulations make provision specifying conditions which would result in additional inspections for the purposes of the Commission's functions under Chapter 2.'.
	Government amendments Nos. 66 to 74.

Ben Bradshaw: Amendments Nos. 62 to 64 and 143 are Government amendments, so I shall speak to them first. Amendments Nos. 62 and 65 are significant and will be of particular interest to the House.
	On amendment No. 62, clause 2 ensures that the commission must have regard in everything it does to the public's views on the services that fall within its remit, and to their levels of satisfaction with those services. The clause received a great deal of attention when the Bill was considered in Committee. User and carer involvement in the commission's work was also a recurring theme, and hon. Members from both main Opposition parties tabled amendments on that issue.
	As I have made clear on a number of occasions, the Government believe that involving and listening to users, patients, their carers and the public will be a central responsibility for the new commission. The Bill already requires the commission to appoint an advisory committee, and we will expect the commission actively to involve patients and service users as well as others with an interest, such as service providers and commissioners.
	There will be a wide range of bodies with an interest in a particular issue or representing particular groups, and we want to ensure that the commission hears their views. For that reason, Government amendment No. 62 proposes to make it explicit that a duty to have regard to the views of the public includes views expressed by representative bodies on behalf of members of the public. That requires the commission to engage with those acting on behalf of members of the public; that might include local involvement networks, charities or other representative groups. I hope that hon. Members will recognise that the proposed measures are a valuable addition to the Bill that will address their concerns and indeed go further, and I hope that they can accept the amendment.
	Amendments Nos. 63, 64, 66, 67 and 143 are minor technical amendments designed to ensure consistency in drafting with the Care Standards Act 2000, which will continue to apply to children's services and services in Wales. Amendment No. 65 is another significant amendment. When we considered the Bill in Committee, the hon. Member for Romsey (Sandra Gidley) tabled an amendment to oblige the commission to publish its inspection reports. I said that I would be happy to consider the matter, and amendment No. 65 is our response to that commitment.
	Clause 57 requires the commission to produce a report when it undertakes an inspection and to send a copy to the provider or manager in question. As it stands, the clause allows the commission to choose whether to publish the report. As I said in Committee, there is no explicit duty on the current commission to publish reports either, although it normally makes them available online. However, I made it clear that I agree absolutely that the public should have access to the commission's inspection findings. Having had the opportunity to review the drafting, I am happy to introduce amendment No. 65, which will oblige the commission to publish its inspection reports. I trust that hon. Members will feel able to accept the amendment.
	Amendment No. 68 is a consequential amendment that relates to section 134(6) of the Mental Health Act 1983. It will update a reference to section 121 of that Act. It is necessary because the relevant part of section 121 will be replaced, through schedule 3 to the Bill, by proposed new clause 134A. Amendments Nos. 69 to 74 are minor consequential amendments, necessitated by the Bill, to the list in schedule 5.
	I turn to amendment No. 142, the only Opposition amendment in the group. It seeks to allow the Secretary of State to specify in regulations specific circumstances in which the Care Quality Commission would be required to carry out additional inspections; such regulations could be made only after consultation with the commission itself. As I said in Committee, I understand the intention behind the amendmentthat is, to allow an ability to set specific triggers for the commission to carry out additional inspections. However, clause 57 already allows regulations to prescribe important aspects of inspection if necessary; there is no need to be more prescriptive.
	The Care Quality Commission will be established as an intelligent regulator. It will take account of a whole range of information to assess risks in respect of providers and the services that they provide. Based on that, it will decide when and how frequently to visit providers and which issues require more detailed investigation. That will build on the approach already being developed by existing regulators to target inspection when action is required. It will therefore not be for the Secretary of State, but for the commission, on the basis of its intelligence, to determine the appropriate triggers for inspections over and above what is set out in regulations. I invite the hon. Member for Romsey (Sandra Gidley) not to press the amendment.

Stephen O'Brien: We are discussing Government amendment No. 62 and the ensuing ones in the group; again, we have a host of Government amendments. Some are concessions that have arisen from Committee, but the question remains about why they had to appear at this late stage.
	In amendment No. 62, the Government are making an important concession on patient and public involvement in health. The Government promised a number of times in Committee to revisit the issue on Report. The drafting of the amendment is, to say the least, disappointingly unambitious. I am concerned that the amendment will open the door for any group that claims to speak on behalf of members of the public to harangue the new commission. We will return to the issue when we discuss the next grouping of amendments, but why are the Government fighting so shy of putting LINksthe bodies that they have createdinto the Bill? Surely that is not because they have no confidence in the bodies themselves. Is it that, as the hon. Member for Tamworth (Mr. Jenkins) pointed out in Committee, the Government are worried that the bodies will be disbanded in the near future, following hard on the heels of the community health councils and the forums?
	I hope that the Minister will expand on amendment No. 68; in Committee we had a number of discussions on the withholding of mail from prisoners detained under the Mental Health Act 2007, an issue of specific concern to the current Mental Health Act Commission. Can the Minister guarantee that the status quo will not change?
	The hon. Member for Romsey (Sandra Gidley) tabled amendment No. 142 to clause 57, which is concerned with regulation. Clause 64 is entitled Avoidance of unreasonable burdens in exercise of regulatory powers. We have proposed that when the CQC increases regulation, an affirmative resolution should be brought before the House. We found that the Government were most resistant to that idea; as I have placed that on the record, I hope that the matter will be taken up with alacrity and fierce argument in another place.
	The amendments on the CQC go hardly any way towards addressing the many and deep concerns expressed by the Committee and a number of third-party organisations; the letter published in today's issue of  The Guardian testifies to that. It seems to suggest that the Government have lost the confidence of a lot of members of the voluntary sector. There is still no mention of carers among the skeletal functions of the CQC, listed in clause 2. I say skeletal, because for the most part this is skeleton or portmanteau legislationthe body is to be added later, by regulations. That is most noticeable in clause 2, which establishes no overarching function. Indeed, the advertisement for the chair of the commission, already online despite the fact that the Bill has not been passed by either House, states that one of the role's responsibilities will be developing plans for the development of the commission's functionsan interesting job spec if ever there was one.
	There are still real concerns that social care and the work of the Mental Health Act Commission will be squeezed out in the action of the new commission. To ameliorate the problem, we have sought a separate reference board of commissioners and an executive board to run the commission. Despite the Minister's contention that the CQC is to be free to establish its own direction, the Government have not left space in the legislation for it to establish the most effective system of corporate governance. Furthermore, there are real concerns that the Government are playing politics with the merger, and ultimately with the well-being of patients and service users, through the prevention of special reviews until after 2010that is, after what will be an increasingly rocky election period for a failing Government and a dithering Prime Minister. We will seek to overturn the issue in another place to prevent that politicking from influencing the important substance of the Bill.
	Dame Denise Platt of the Commission for Social Care Inspection has expressed concern that many of the commission's functions will become permissive rather than statutory, as they currently are, and that they will therefore be the first to be ditched when the Government put on the financial squeeze. The Government seem unable to get the issue right. What guarantees can the Minister give that they will not scrap this in three years' time?
	The 1998 White Paper Modernising Social Services proposed structural change. The Care Standards Act 2000 created a single England-wide National Care Standards Commission, which was launched in 200217 days later, the Government announced that it was to be abolished. The Health and Social Care (Community Health and Standards) Act 2003 created the Commission for Social Care Inspection, which was launched in 2004, incorporating the social care responsibilities of the National Care Standards Commission, the work of the Department of Health social services inspectorate and the SSI-Audit Commission joint review team. In 2004, the Government's arm's length body review ruled out a merger with the Healthcare Commission. In his 2005 Budget statement, the then Chancellor announced the merger that we are debating today. Need I say more? Can the Government guarantee that all the work that we are putting in today will not be scrapped within three years?
	This scandalous provision remains in the Bill. It forces the CQC to have regard to such aspects of Government policy as the Secretary of State may direct; as such, it totally undermines the independence of the body. The Healthcare Commission has put on record its concerns about the timing of the legislation and that the costs will be high and the distraction considerable. It was disappointing therefore that the Government chose not to include the cost of the merger with wind-up costs of 140 million in any risk assessment.
	The House should also be aware that the merger is saving almost nothing on the efficiency trend that the three commissions themselves have already established just as they were bedding in. Taxpayers are paying 140 million for a merger and rebrand that will probably save them no extra money. Furthermore, parts of the cost savings are due to the commission losing the responsibility for complaints handling. That will be transferred to the ombudsman, but we have had no costings on the increase of her budget in the face of an elevenfold increase in work load. We also have no information on how this will be wound up and transferred.
	Despite all their amendments, the Government have yet again not got things right. They have not had sufficient ambition when they have sought to address the concerns that have been raised. I hope that the Government have only put down a marker for what will be truly beefed up, made proper and substantive in another place, so that health care needs are met and patient representation and protection are secured.

Sandra Gidley: When I first read Government amendment No. 62, I thought it a good idea. However, I had a cynical afterthoughtI wondered whether it was a spoiling amendment for the LINks amendments tabled by the Conservatives. On the face of it, amendment No. 62 seems to address some of the many concerns raised in Committee about there being an insufficient patient and public voice in the new commission. However, I am not sure that the insertion of the words or on behalf of has been fully thought through. They are rather vague. It is not clear, for example, who decides who should speak on behalf of whom.
	I can imagine the Government's reaction if Opposition Members had tabled a similar amendment in Committee: we would have been told that there was no specificity and no clarity about who could speak on behalf of whom. Are we talking about bodies that have a constitution so that it is clear on whose behalf they speak, or advocacy services that may speak on behalf of the individual? Where is the protection for an individual who does not want anybody speaking on their behalf? Some mental health groups are very particular about their views on things, and I can envisage problems where other people might purport to speak on their behalf. I am a little confused by the vagueness and wonder whether any further clarity is yet to come.
	I thank the Minister for amendment No. 65, which almost deals with the concerns raised when we discussed amendment No. 239 in Committee. At that stage, his argument against the amendment was that there were occasions when vulnerable children or adults must be protected, and I wondered how that would be resolved. I do not mean to sound churlish. I am delighted to see the amendment, but curious about the reasoning.
	Liberal Democrats tabled amendment No. 142 after discussion with Unison. We discussed the relevant issues in Committee, but there is still concern about the triggers for inspection. The Minister claims that that is dealt with in the Bill and that it is not a problem. However, there is a problem where an inspection is due within a prescribed period but there may be factors that would alert people to the need for an inspection to be done more rapidly. There may be risk factors that could, particularly in a care home, lead to the quality of care deteriorating rapidly where a provider had previously been rated good and placed on a three-year inspection cycle. Those could include a change of ownership of the providerwe have all seen cases of nursing homes where that has been evidentor a change of registered manager, which can have a huge impact. Adult protection matters may come to light. It might be something as simple as staff turnover, sudden increases in which often indicate that something else is going wrong. If there is to be an automatic three-year inspection cycle, there must be an early warning system. We would not want to go back to a situation where there had to be a number of complaints before somebody realised that there was cause for concern.
	The Government have said that the principles of inspection for the CQC will be proportionate and risk based with a view to lightening the burden of regulation for health and social care providers. We would all agree with that general sentiment. However, the new inspection methodology is much more reliant on paper-based reviews and providers assessing themselves. I have occasionally had that concern in relation to CSCI. Sometimes, the first person who is asked to provide a report when there is a complaint is the manager of the care home whom the report is against, and of course people will try to present themselves in the best light possible. There are concerns that the moves towards light-touch regulation could have significant implications for public and staff safety, at a time when the Government are trying to encourage more private providers into the market.
	The Minister said that it will all be okay, but he has a job of reassurance to do. As the hon. Member for Eddisbury (Mr. O'Brien) highlighted, the budget that the new commission will operate with will be 40 per cent. less than what the previous regulators had, so it may be driven by budget imperatives rather than what is best for users of health and social care services. A recent survey of Unison members working for the CSCI found that 76 per cent. believe that the new inspection methodology does not provide a robust assessment of risk to service users. A common belief was that the reduced inspection programme could lead to staffing cuts, and fewer inspectors are less likely to impose enforcement requirements because there will not be enough time to follow them up.
	It is not only me that the Minister has to reassure. A body of people out there are committed to doing a good job of work for CSCI, and deal with these problems day in, day out. They are concerned that problems will escalate unless there is a clear framework for alerting people to potential problems at a very early stage in the proceedings.

Kelvin Hopkins: My hon. Friend the Minister may know that I have been to visit the Minister with responsibility for care homes with a delegation from Unison, and we expressed concern about the risk-based approach to inspection. I know that my hon. Friend gave assurances about this in Committee, but there are ongoing concerns. If, in time, there are cases of care homes where the lighter-touch inspection has led to a lowering of standards of care, or the sense that they will no longer be visited so frequently and therefore do not need to perform quite so well, that could eventually lead back to the Government's door. My hon. Friend is conscientious and concerned about these matters, but this could come back to haunt the Government unless it works. We have already had reports in the past couple of weeks about care homes where there have been serious infections or the inspection was not sufficient to ensure that they had performed well. While I accept my hon. Friend's sincerity about the matter, some will continue to have concerns about the light-touch approach and the risk-based inspection system. This may have to be revisited in future unless it works as well as he suggests.

Ben Bradshaw: I welcome the fact that the hon. Member for Eddisbury (Mr. O'Brien) recognises amendment No. 62 as an important concession, but it was not clear from his comments whether he was criticising us for going too far or not going far enough. I am not likely to get that clarification at the moment, as he is not here. The hon. Member for Romsey (Sandra Gidley) put her finger on it when she gave an example of how sensitive some patient and user groups are about organisations claiming to speak on their behalf. That is why we have broadened this out significantly to include groups who speak on people's behalf, not just a single organisation, although I specifically referred to LINks. I urge hon. Members on both sides of the House to give LINks a chance before writing them off.
	To reassure the hon. Member for Eddisbury on the retention of the status quo on the Mental Health Act 2007, I draw his attention to amendment No. 68. I could have gone into that in more detail, but that is what that amendment does with regard to the rules on the opening of post.
	The hon. Gentleman asked me to guarantee that the new regulatory landscape will not be scrapped again in three years' time. If, as I hope, there is still a Labour Government in three years' time, I can give him that assurance. There was a general recognition in Committee that the Bill finishes the job that we began several years ago. In fact, as we discussed at some length, some Liberal Democrats urged this integration on us at the time of the last reorganisation of the regulatory system, but we felt that the timing was not right and that it made sense to allow the existing regulatory bodies to settle down and do their joband they have done a very good job. Even from the bodies that face abolition, there was a recognition of the desirability of the principle of integration. Once that has taken place, everyone feels that we will need time for the new regulatory system to bed down.
	In response to the hon. Gentleman's question about the complaints processsomething we discussed at some lengthI draw his attention to the memorandum submitted by Ann Abraham on 14 January, which spells out clearly how she expects to meet this challenge.
	 Amendment agreed to.

Stephen O'Brien: I beg to move amendment No. 131, page 2, line 11 at end insert
	'(aa) views expressed to them by Local Involvement Networks.'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following amendments:
	No. 136, in clause 92, page 45, line 47, at end insert
	'Local Involvement Network has the meaning given to it by section 222 of the Local Government and Public Involvement in Health Act 2007 (c.28);'.
	No. 132, in clause 103, page 51, line 8 , at end insert
	'(aa) Local Involvement Networks,'.
	No. 133, page 51, line 9, before 'bodies', insert 'other'.
	No. 134, in clause 112, page 56, line 16, after 'public', insert
	'(aa) Local Involvement Networks,'.
	No. 135, page 56, line 17 , before 'bodies', insert 'other'.
	No. 137, page 66, line 15, at end insert
	'Local Involvement Network has the meaning given to it by section 222 of the Local Government and Public Involvement in Health Act 2007 (c.28);'.

Stephen O'Brien: I am grateful to you, Mr. Deputy Speaker, and I apologise for the fact that I had to absent myself briefly from the Chamber towards the end of the debate on the previous group of amendments.
	We come now to local involvement networks, and it will not have escaped your notice, Mr. Deputy Speaker, that we had a partial discussion about them in relation to Government amendment No. 62, which sought to make clause 2 read:
	In performing its functions the Commission must have regard to
	views expressed by or on behalf of members of the public about activities to which the functions relate.
	I pay tribute to the co-sponsoring of our amendments by the hon. Members for North (Kelvin Hopkins), for North-West Leicestershire (David Taylor) and for Romsey (Sandra Gidley). Amendment No. 131 would make it explicit that LINks were one of the groups that the commission must have regard to. Amendment No. 132 would include LINks as a group that the Office of the Health Professions Adjudicator must seek the views of, and amendment No. 133 is consequent to that. Amendment No. 134 would include LINks as a group that the Commission for Healthcare Regulatory Excellence must seek the views of from time to time, and amendment No. 135 is a consequential amendment. Amendment No. 136 defines LINks for the purpose of part 1, and amendment No. 137 defines them for the purpose of part 2.
	I welcome the concession that the Government have made to the arguments advanced by me and Committee members of all parties that LINks should be consulted by the Care Quality Commission. Unfortunately, having promised a number of times in Committee to revisit the issue on Report, the Minister has been disappointingly unambitious in his amendments, which were accepted without opposition. I will not suggest, therefore, that those amendments show more of the contempt that many, including me, have accused the Labour Government of showing in their treatment of the patient voice in England. They scrapped community health councils, which I was very involved with. I exposed an answer given at Prime Minister's questions: the Prime Minister said that there had been consultation when it was announced that they would be axed in the July 2000 NHS plan, but there had not.
	The patient and public involvement forums are now also to be replaced, and if LINks are not mentioned in the Bill, the Government's latest solution could appear as a vote of no confidence in them. That perception is held by the hon. Member for Tamworth (Mr. Jenkins), who noted in Committee that the reason for not prescribing LINks in the Bill was
	in case it ceases to exist during the lifetime of the Bill. [Official Report, Health and Social Care Public Bill Committee, 17 January 2008; c. 284.]
	The hon. Member for Luton, North, who is co-sponsoring the amendments, told the Committee that
	ever since the community health councils were abolished Labour Members have been concerned about the strength of protection for patients and of patient representation. [Official Report, Health and Social Care Public Bill Committee, 22 January 2008; c. 412.]
	I admire him for saying that. He is right and it needed to be said.
	I will not rehearse the arguments made in Committee, but simply note a few essential points in support of the amendments, the most vital of which is amendment No. 131. In December 2005, an independent review of the regulatory framework of the NHS, ordered by the Department of Health, concluded:
	Establishing representative national and regional fora to contribute a reasoned collective consumer perspective to the process of reform could well improve both the efficacy and legitimacy of that reform.
	In their response to the consultation preceding the Bill, the Government stated:
	The Care Quality Commission's...priority will be to safeguard service users and help improve their experience of health and adult social care servicesrecognising that it can only do this effectively by involving them.
	I note that Ofcom has a consumer panel that plays a similar role, which convenes a regular consumer forum of interested parties, such as consumer and disability organisations.
	In its written evidence to the Committee on this Bill, the Healthcare Commission stated it considered the first clear principle
	underpinning the design of a regulatory framework
	to be that the
	regulatory system should focus on the needs of the patients and the public.
	The Commission for Social Care Inspection put it even more strongly:
	It would be useful if there were an explicit expectation that the new care Commission had a relationship with Local Involvement Networks.
	That is precisely what our amendments seek to achieve. It is clear that there is a genuine and grand opportunity for the Minister to accept that the amendments are workable and desirable.
	The Government are giving a vote of no confidence to their own system by leaving LINks out of the Bill, which is another nail in the coffin of genuine patient and public involvement. As I said, that process began with the abolition of CHCs. We are disappointed that the Government have not used the opportunity offered by this Bill to steal our policy of creating HealthWatch, a national consumer voice for patients. HealthWatch would provide support to patients at a national level and leadership to LINks at a local level. It would incorporate the functions of the independent complaints advisory body; make representations to the NHS board on such things as the closure of NHS services; and, subject to consultation, it would have a statutory right over guidelines issued nationally concerning the care NHS patients should receive and over decisions that affect how NHS care is provided in an area. Hopefully, the Government will support us when we introduce our NHS autonomy and accountability Bill. That would be welcome, and consistent with what the Government are purportedly seeking to achieve.
	Now that the Government amendments have been accepted, I am concerned that the door is open for any group that claims to speak on behalf of members of the public to harangue the new commission, or engage it in some difficult dialogue. We also note that there is no duty to consult, only the weak phrase have regard to. That weakness is repeated in relation to other organisations mentioned in the Bill. The hon. Member for Luton, North, who has studied the matter carefully, pointed out in Committee that clause 103, which deals with the OHPA, is entitled Duty to consult and contains the phrase seek the views oftwo very different things. A similar wording is used with regard to the CHRE. The title of clause 112 talks of a duty to consult, but again we find the phrase seek the views of in the text of the clause.
	Our amendments would beef up the consultation carried out by such bodies by including LINks. I commend the amendments standing in my name and those of my right hon. and hon. Friends, and Members from the Labour and Liberal Democrat Benches. This is a genuine cross-party approach to the matter, so I hope that the Government will feel persuaded.

Kelvin Hopkins: I have agreed to attach my name to the amendments, alongside that of my hon. Friend the Member for North-West Leicestershire, because Members in my party have been concerned about the strength of patient representation for some time, and it is right that those concerns are raised from time to time so that the Government are made aware of them. The abolition of community health councils and the switch to the patient and public involvement forumsand now to LINksshow that the Government are concerned about patient representation, but I am not sure whether they want to strengthen it, or have had pressure put on them to weaken it in some way.
	I know that the then health authority perceived the community health council in my area to be a nuisance. The primary care trust has regarded the patient and public involvement forum in our area, especially its chair, as a nuisance. However, patients' representatives should be a nuisance. If they make a lot of noise, perhaps there is a basis for what they are doing. I hope that my hon. Friend the Minister and the Government will reconsider giving a role to LINks in the way in which the amendments suggest. Perhaps they will table their own amendments if the ones that we are considering are defeated.
	I repeat a point that I have made several times about local authority democratic accountability. When most long-term care homes were in the public sector, there was recourse to local councillors and local democratic representation. With privatisation and subsequent institutional reform, that local democratic accountability was lost. Indeed, many families now come to their Members of Parliamentmore than one constituent has approached meabout problems with care homes. There should be a stronger role for patient representation and I hope that that view can be accommodated in the Bill before it receives Royal Assent.

Sandra Gidley: Local involvement networks are the Government's proposed solution to public and patient involvement. If they are as good as they are cracked up to be, and are to deliver all that the Government claim, why does the Minister not accept the amendments, which would strengthen the role of LINks? Are the Government not 100 per cent. convinced that LINks will prove an effective system?
	The Select Committee on Health looked into LINks and public and patient involvement, and it was apparent that, despite the expertise of the range of experts who came to speak to us, there was no clear idea about the final structure of LINks and how they would work in practice, or even what their functions would be. There was disappointment that some of the functions of the old CHCs were missing. That could be explained by the mantra that we want local solutions and that they will be different in different areas. I subscribe to that point of view to some extent. However, I was struck by the uncertainty about how LINks would work.
	In the next couple of years, while the networks find their way, it could be said that we face a democratic deficit. Perhaps the Minister can reassure us that our concerns about how LINks will work are unfounded and that they genuinely are the best thing since sliced bread. If they are, there is no reason for not accepting the amendments.

Ben Bradshaw: The amendments lead us into territory that is familiar to those of us who sat through the Committee proceedings: the role of local involvement networks. The amendments again try to put LINks on the face of the Bill, in the provisions for the Care Quality Commission, the Council for Healthcare Regulatory Excellence and the Office of the Health Professions Adjudicator. Let me first deal with amendments Nos. 131 and 136.
	As we specified in the previous debate and in Committee, we all want the Care Quality Commission to have a clear duty to engage with and be responsive to interested parties. I was therefore pleased to move Government amendment No. 62 to clarify the issue. In Committee, we discussed hon. Members' desire for the CQC, the CHRE and the OHPA to be independent. However, the amendments would prescribe the bodies to which those independent organisations should pay regard. That is not a sensible way to proceed. Government amendment No. 62 makes it clear that the CQC should have regard to the views of organisations that represent patients. As the hon. Member for Romsey (Sandra Gidley) said earlier, there may be specialist care investigationsfor example, organisations might want to pay regard to the users of mental health services or other specialist groups. We do not believe that limiting the groups to which they should pay regard to LINks is sensible. That does not mean that we do not have confidence in LINkswe have every confidence that they will do an excellent job and we expect the CQC to work closely with them.

Sandra Gidley: The Minister has demonstrated why the concept seems so nebulous. Some people argue that all the groups to which he said that due regard might be paid would have a feeding-in mechanism through LINks. Does he now claim that that is not the case?

Ben Bradshaw: No. They may well do that and I hope that they will. I do not intend to extend the debate to become one of those that we held at length when LINks were established. The hon. Lady made a good point earlier that some patients and some patient and user organisations sometimes resent other organisations speaking on their behalf. We do not want to prescribe that the CQC should pay regard only to LINks, and not to other patient and user organisations.
	Although Government amendment No. 62 was tabled in the same spirit as amendment No. 131, it has the distinct advantage of leaving the door open for other representative groups and for leaving it to the independent commission to determine for itself the most effective way in which to engage appropriate groups. Given the amendment that we have just accepted, we believe that amendment No. 131 and consequential amendment No. 136 are unnecessary.
	Amendments Nos. 132, 133, 134 and 135 would insert into clauses 103 and 112 a duty on the Council for Healthcare Regulatory Excellence and the Office of the Health Professions Adjudicator to seek the views from time to time of LINks in addition to other bodies. Amendment No. 137 is simply a consequential amendment to define Local Involvement Network in clause 122. Under the Bill as drafted, the CHRE and the OHPA are both required to consult public and representative bodies on exercising their functions. We believe that those independent bodies are best placed to decide from which other bodies they should seek views.
	Indeed, the council has already embarked on a programme of work, which will lead to the implementation of a patient and public strategy. That is being designed to ensure that the council can fulfil the proposed statutory function of becoming an authoritative voice for patients.
	I reiterate what I said in Committee about arrangements between LINks and the CQC. Although we want to encourage strong relationships between LINks and their key stakeholders, including the CQC, the CHRE and the OHPA, we do not believe that it is appropriate to dictate to those statutory and independent bodies the way in which they should involve LINks in inspections or consultations. I hope that, given our discussion, the hon. Member for Eddisbury (Mr. O'Brien) will withdraw the amendment.

Stephen O'Brien: Obviously, I listened carefully to the Minister's arguments, which are not unfamiliar to those of us who had the pleasure of serving in Committee.
	There is a need to recognise the theme of a long absence of understanding the issue at stake. When community health councils were axed, they were regarded by some as a nuisance, which probably means that they were doing their job. Some were not very good, but the vast majority were perceived as doing a good job. They were seen to be independent and therefore to be trusted by people who needed help when they felt most vulnerable and needed to have their hand held when charting their way through the confusing and labyrinthine process of NHS complaints.
	LINks are the ultimate successor bodies that we are now faced with. If we could feel that they were being given the necessary importance by being included in the Bill, it would seem that the Government were at last addressing the grave concern that so many of us have about the lack of importance and independence given to representing patients and their concerns, particularly when things are going wrong with the NHS. Most often, those who have a concern about the NHS have a continuing need of it and are most anxious not to get offside with the very people from whom they think they need an immediate and expert public service. Taking the opportunity to demonstrate how much they are committed to patient and public involvement in that way would be the proper manner in which the Government could reflect that commitment.
	The Government now have a real opportunity to pick up a policy that they have been urged to adopt, but which they again seem to be resisting, and which we have articulated at length elsewhere and now in a draft BillI hope that I will be able to persuade the Minister and his colleagues to support the NHS accountability and autonomy Bill, in which we have a designed patient and public involvement system through HealthWatch, a good model that, despite the Minister's disparaging so far, I hope will be picked up.
	It is vital to recognisenot least because the amendment was not just tabled by the official Opposition, but co-sponsored by Government Members and the Liberal Democrats' spokesmanthat the House now has an opportunity to vote, with a heavy heart and some displeasure, against the Government for not seeking to pick up on a sensible, measured and appropriate way of handling such an essential issue. This is an opportunity to ensure that that is well understood in the Bill, and I shall therefore press my amendment to a Division.

Question put, That the amendment be made:
	 The House divided: Ayes 179, Noes 267.

Question accordingly negatived.

Philip Hammond: On a point of order, Mr. Deputy Speaker. The timetable motion relating to tomorrow's business, which the Leader of the House told us would be tabled later today, has still not been tabled in the Table Office. It is difficult for those of us who are trying to prepare for tomorrow's concertinaed business to do so in the absence of an understanding of the timetable. Do you have any knowledge of when the timetable motion is to be laid, or any ability to influence that timing?

Mr. Deputy Speaker: I do not have any knowledge of how that matter is progressing, but I hope that the hon. Gentleman's placing it on the record will be heard. As the House knows, Mr. Speaker is always anxious that information that is vital to the work of the House should be made available as quickly as possible.

Clause 25
	  
	Warning notice

Amendment made: No. 143, page 13, line 29, after second 'registration', insert ', the removal of a condition'. [Tony Cunningham.]

Clause 27
	  
	Urgent procedure for variation or suspension

Amendments made: No. 63, page 14, line 34, after 'vary', insert 'or remove'.
	No. 64, page 14, line 43, after 'varied', insert ', removed'. [Tony Cunningham.]

Clause 57
	  
	Inspections carried out for registration purposes

Amendment made: No. 65, page 28, line 23, leave out 'may' and insert 'must'. [Tony Cunningham.]

Clause 84
	  
	Guidance by the Commission in relation to enforcement action

Amendments made: No. 66, page 41, line 30, leave out from '8(5)' to end of line 31 and insert '(variation, removal or imposition of condition in relation to registration as a service provider),'.
	No. 67, page 41, line 32, leave out from '11(5)' to end of line 33 and insert '(variation, removal or imposition of condition in relation to registration as a manager),'. [Tony Cunningham.]

Clause 95
	  
	Fitness to practise panels

Ben Bradshaw: I beg to move amendment No. 23, page 47, line 6, leave out from first 'the' to end of line 7 and insert
	'list of persons eligible to serve as chairs provided for by section 96(1)(aa),'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following amendments: No. 85, page 47, line 6, leave out from first 'the' to end of line 7 and insert 'legally qualified members list'.
	No. 82, page 47, line 7, at end insert 'or the legally qualified members list'.
	Government amendments Nos. 24 to 27.
	No. 83, page 47, line 17, at end insert
	'legally qualified members list means the list of persons eligible to serve as legally qualified members provided for by section 96(1)(c).'.
	No. 87, page 47, line 17, at end insert
	'legally qualified means
	(c) a person with a 10-year general qualification within the meaning of section 71 of the Courts and Legal Services Act 1990 (c. 41),(d) an advocate or solicitor in Scotland of at least 10 years' standing, or(e) a member of the Bar of Northern Ireland, or a solicitor of the Court of Judicature of Northern Ireland, of at least 10 years' standing.'.
	Government amendments Nos. 28 and 29.
	No. 84, clause 96, page 47, line 26 , at end insert
	'(c) persons eligible to serve as legally qualified members.'.
	Government amendment No. 30.
	No. 75, page 47, line 37, at end insert
	'(b) legally qualified means
	(i) a person with a 10-year general qualification within the meaning of section 71 of the Courts and Legal Services Act 1990 (c. 41),
	(ii) an advocate or solicitor in Scotland of at least 10 years' standing, or
	(iii) a member of the Bar of Northern Ireland, or a solicitor of the Court of Judicature of Northern Ireland, of at least 10 years' standing.'.
	Government amendments Nos. 31 to 37.
	No. 89, in clause 107, page 53, line 26, at end insert
	'(2A) Any proceedings to which subsection (1) applies must have a legally qualified chair.'.
	No. 90, in page 53, line 26, at end insert
	'(2A) Any proceedings to which subsection (1) applies must have a legally qualified chair or a legal assessor.'.

Ben Bradshaw: The amendments will allow the Office of the Health Professions Adjudicator to appoint and use legally qualified chairs for panels hearing fitness to practise cases. The Bill as introduced provided for chairs to be chosen from either the lay or professional lists, with the panel having a legal assessor to advise on points of law. However, I thought that the evidence given to the Committee by Lady Justice Smith and the General Medical Council warranted further thought. Lady Justice Smith said that
	there are many reasons why I think that we should have a legally qualified chair, the main one being that to do the job well requires legal expertise.
	Findlay Scott, the chief executive of the GMC, said that
	if there is an argument for a legally qualified chair, I do not personally believe it lies in the quality of the decisions. There may be real arguments in relation to the ability of a senior lawyer to control the proceedings in a way that constrains costs while remaining fair to doctors, and I think that that is an argument that deserves to be fully explored. [Official Report, Health and Social Care Public Bill Committee, 8 January 2008; c. 41-57.]
	I therefore agreed in Committee to give careful consideration to that issue, with a view to bringing something back now. That is what these Government amendments represent, and I think that they are a good example of how the evidence-giving process is adding value to the system of parliamentary scrutiny.
	Essentially, the amendments require the OHPA to keep a list of chairs, which will include legally qualified chairs as well as lay and professional chairs. The OHPA will then have the flexibility to set out in rules when it will use legally qualified chairs. I am very clear that it would not be right for the Government to impose legally qualified chairs for every case that the OHPA hears, when this is a relatively untried and untested route in this arena. Instead, the amendment gives the OHPA the option of using legally qualified chairs for as many cases as it thinks it appropriate. For example, the OHPA may set out in rules that all cases involving a high number of witnesses or likely to be particularly lengthy should have a legally qualified chair. However, the rules may also set out that in all cases where the health of the practitioner is the central issue, a lay or professional chair should be used.
	The essential point is that, although I agree that legally qualified chairs should be available to the OHPA, we do not think it right for the Government to prescribe exactly what kind of chair should be used in which circumstances. I would regard it as particularly inappropriate to require the OHPA to use legally qualified chairs in every case before they had been properly trialled and a decision made in the light of practical experience. I hope that Opposition Members will support the amendments.
	Let me deal now with Opposition amendments Nos. 75, 82 to 85, 87, 89 and 90. I hope that the hon. Members who tabled those amendments will agree that the Government amendments very much achieve the same objective and so will feel content not to press their amendments. Amendment No. 85 appears to be designed to ensure that all panels should have a legally qualified chair in all cases. I apologise if I have misunderstood the purpose of the amendment, but it seems to be at cross purposes with amendment No. 82. I do not propose to detain the House by rehearsing my reasons for opposing the amendment, because I have already set out in speaking to the Government amendments why I do not believe it is right to impose legally qualified chairs in all cases.
	Amendments Nos. 75 and 87 would set in stone the requirement for legal chairs to have a 10-year general qualification, which is the same requirement as the General Medical Council currently uses for its legal assessors. However, the General Optical Council requirement for its legal assessors is a five-year general qualification. I am concerned about prescribing a narrow requirement on the face of the Bill, especially when I have tasked the Tackling Concerns Nationally working group under the chairmanship of Sir Ian Kennedy to consider the introduction of legal chairs and other such details. Ultimately, we believe that it should be for the OHPA to decide how best to run its fitness to practise panels within the framework set by Parliament, taking into account the recommendations of the working group. Rules covering the detail will be laid before Parliament and will be subject to the negative resolution procedure.
	Amendments Nos. 89 and 90 would require all health profession regulators using the civil standard of proof to have legal chairs or at least legal assessors in all cases. I remind the House that the majority of these regulators already use the civil standard. I am sure that Opposition Members do not want to push the whole swathe of regulators into the unknown. If the evidence pointed in such a direction, powers under section 60 of the Health Act 1999 could be used after appropriate consultation. As hon. Members are no doubt aware, a section 60 order will be subject to the affirmative resolution procedure. On that basis, I hope that the Opposition will not press their amendments.

Stephen O'Brien: This group includes Government amendments as well as those tabled by my hon. Friends and by me. The amendments arose as a result of the evidence-taking sessions. As the Minister pointed out, they help to reinforce the value and benefit of such sessions. I welcome the beginnings of an important concession by the Government to the strength of our arguments on legally qualified chairs. I remind the House that the Committee divided on this matter in order to hold the Government's feet to the fire during the sitting.
	I shall not go over the arguments again at length, as they were covered more than adequately in the  Hansard of Committee proceedings from column 372 onwards. However, the provisions on legally qualified chairs arose from recommendation 79 of the fifth report of Lady Justice Smiththen Dame Janet Smithon the Shipman inquiry. She said:
	In the event that the GMC retains control of the adjudication stage, it should appoint a number of legally qualified chairmen who should, as an experiment or pilot, preside over more complex FTP panel hearings. The results of the pilot scheme should be scrutinised to see whether there are benefits, whether in terms of the improved conduct of hearings, more consistent outcomes, improved reasons and/or fewer appeals.
	All hon. Members felt that there was extraordinarily impressive and persuasive oral evidence relating to effective chairmanship, speed of proceedings, a higher standard of reasoned decision and an ability to deal with the complexities of the civil standard of proof. That evidence can be seen in column 37 of the  Official Report of Committee proceedings.
	It will not have escaped the notice of the House that one aspect of introducing the civil standard of proof in the hearings is the complexity of its administration as a matter of adjudication and law, not least in ensuring that justice is done and seen to be done. As I shall try to explain, it has variability within it, unlike what we used to call the criminal standard of proof, of being beyond all reasonable doubt, or as is more common nowadays, the standard of being sure.
	I am pleased that the Government have introduced proposals for a list including legally qualified persons. The Minister has outlined that point in speaking to Government amendment No. 23, which was a response, as he knows, to the demands we made in Committee at column 374 of  Hansard. Nevertheless, I have to say that our amendments Nos. 82, 83 and 84 are a neater way of delivering what he has sought to achieve in Government amendment No. 23. That amendment is intended to supplant, from the Government's perspective, our amendments Nos. 82 to 84, so I believe that we should see these as a coupled set of arguments. I am pleased that the Government amendment was designed to draw on the arguments made in Committee, as reflected in the amendments.
	A number of concerns remain, however, particularly about the application of the civil standard of proof, the speed of proceedings and the definition of legally qualified. On the standard of proof, the Bill moves fitness to practise panels away from the criminal and towards the civil standard of proof. In layman's terms, it is a move from beyond reasonable doubt or being sure to a balance of probabilities. We debated that point in Committee, as is shown in column 395, but unresolved issues remain and it is right for us to bring them up again on Report.
	There seem to be good reasons for the use of the civil standard and few differences between the parties arose in Committee. Indeed, Opposition Members supported the Government, but we remain concerned about the lack of piloting, particularly with regard to doctors. That problem still needs to be dealt with. I hope those reflecting on the Bill as it goes to the other place will give that issue some further urgent and important consideration.
	The concern arises because a statutory application of the civil standard results in a common law interpretation on a sliding scale that is difficult to reflect on the statute book. Consequently, a doctor before a panel faces an ever-rising hurdle in attempting to clear his or her name. The civil standard of proof will not be applied uniformly across the boarda very important point made by Lady Justice Smith in her evidence at column 38. This issue is important not just for the doctor, but for those sitting on the panels. They must have a clear understanding at the outset of what standard of proof on the balance of probabilities actually means on a sliding scale. Until they know the evidence, they cannot be sure of the standard of proof against which the truth must be tested. That is critical in the ultimate case where someone's livelihood is threatened and their fitness to practise questioned. There is a burden on adjudicators to ensure that their decisions are just and fair, made in a properly conducted way and, above all, not capable of being contested too easily by appeal. People must feel that the system is proper and fair to both parties when these very serious issues come before these panels.
	Another reason Lady Justice Smith gave for the use of legally qualified chairs was that it enabled hearings to be dispatched more quickly. We are all interested in securing efficiency and speed in such things, without causing any prejudice to the application of justice. She said:
	Legally qualified people who appear in front of such tribunals are capable of running rings around the tribunal if no one on the panel is legally qualified. [Official Report, Health and Social Care Public Bill Committee, 8 January 2008; c. 37.]
	The GMC, which has lobbied against the universal application of legally qualified chairs, has failed to answer that pointsomething to which she also referred. She went on to say that while it is true that the broad quality of judgments currently made is indeed highI am in no way seeking to criticise the GMC for the conduct of its hearings and how it has trained peopleit would be better for all concerned if panels could be conducted no less thoroughly but more efficiently.
	It is with the issues of speed, efficiency and the application of the civil standard of proof in mind that we tabled amendment No. 85, which would make all fitness to practise panels subject to a legally qualified chair. Interestingly, to add substance to that point, page 4 of a document supplied by the Government themselves on 7 February in relation to professional regulation shows the cost of a three-person panel with a legally qualified chair for some fitness to practise cases and the cost of a three-person panel with a legal assessor for the remainder. Where legal chairs are used in 10 per cent. of fitness to practise cases, the estimate is 2.565 million. If they are used in 25 per cent. of fitness to practise cases, the estimate is 2.489 million, and it comes down to 2.374 million if they are used in 50 per cent. of such cases. That helpful Department of Health document implies that if we used legal chairs in 100 per cent. of such cases, it would have the same trend in saving money and, as Lady Justice Smith would argue, in the increased dispatch, speed and efficiency of the cases. Therefore, the Department of Health itself has already laid out a good taxpayer value-for-money point on how it would be more efficient to use legally qualified chairs in all cases.
	I am disappointed that the Government are unwilling to define legally qualified in their amendment No. 30. Amendment No. 75 would help us to have that definition, and links to amendment No. 85, which would ensure that there is a qualified chair for all such cases. The Bill is in many regards a portmanteau Bill, with many of its powers devolved to rules and regulations. More than a quarter of the clauses relate to secondary legislation. It is perverse to leave to regulation what could easily be prescribed on the face of the Bill under the proper scrutiny of the House.
	The Bill contains a definition of legally qualified in paragraph 6 of schedule 6. Lady Justice Smith noted and commended that definition in oral evidence, at column 39. In Committee, my hon. Friend the Member for Rugby and Kenilworth (Jeremy Wright), who is not in the Chamber but has been assiduous in his attendance of our proceedings, made the excellent point that a legally qualified chairman would need not only legal experience but judicial experience. It is important to reflect on that.
	Having taken considerable advice, I had hoped that as Government amendment No. 23 went some way to making a concession on the grounds that we have advanced, I would not have to oppose it. However, I wanted to put amendment No. 85 to the vote, because what it contains is right and many outside this place would like to see it tested. Unfortunately, I am told, on the advice of the Clerks, that I cannot do that, which is much to be regretted. Procedure has overwhelmed what is a fair point, which should be available for testing. However, having put that difficulty on the record, I hope that it will be seen by those in another place who are exercised by such things. Many of them regard themselves as legally qualified and as having judicial experience. They will think that it is important to envisage how these significant proceedings will work, because they could be vital to protect patients and the public.

Jim Devine: I am one of those individuals who has such experience. Does the hon. Gentleman?

Stephen O'Brien: What we are personally qualified to do is not relevant, because we are trying to frame a Bill that is right for those who do the professional job. As it happens, however, I am a qualified lawyer. I am a solicitor of the Supreme Court of England and Wales. I have not practised for 19 years, but I did practise in the City of London for a number of years. I have no judicial experience, but I had considerable arbitration experience, which is of a judicial nature. What is interesting is that not only has one of the hon. Gentleman's colleagues sat on one of the GMC panels, but so has one of mine. My colleague is legally qualified; the other is not. That is not to say that either has done the job any worse than the other. On the contrary, they both did it well.

Jim Devine: rose

Stephen O'Brien: I do not want to enter into a dialogue. What matters is that plenty of people in another place will be very exercised by this issue, given that Lady Justice Smith gave important and compelling evidence in a most reasoned way. When we heard her evidence, hon. Members on both sides of the Committee were at one in thinking that it was impressive and compelling. She advanced the idea that there should be legally qualified chairs for the bodies. That is why it is important that we give the issue an airing.
	Procedure does not enable us to vote separately on Government amendment No. 23 and amendment No. 85. Amendment No. 23 is only a partial solution. What it sets out is not mandatory; it simply says that there will be legally qualified persons on a list from which the chairman can be chosen. Amendment No. 85 would have made that mandatory. It would have given earnest to what Lady Justice Smith appeared to be advising in oral evidence, for which all Committee members were present. I therefore recognise that I have to place on the record, with my best efforts, a signal to those who will consider the Bill in another place. I know that this sort of issue has exercised them greatly in the past, and rightly so. I would be surprised if we do not have to deal with it again when the Bill comes back to the House with Lords amendments. I very much hope that it will be given a proper airing in the other place, and I expect them to find a way to achieve what procedurally I have not been allowed to do.
	I cannot press amendment No. 85 to a vote, and on the basis of my comments it would be wrong and invidious of me to divide the House on Government amendment No. 23. If anyone sought to put that to a vote, we would abstain because it is better than what we have got, but it is by no means sufficient. I hope that that places on the record our position and that another place will achieve what we have not been able to achieve so far.

Sandra Gidley: Most of what I want to say has been covered by the Minister and the hon. Member for Eddisbury (Mr. O'Brien). We have an interesting example of how the new evidence sessions have been useful. I cannot recall a single submission from the great and good in Second Reading briefings or the like on legally qualified chairs. We raised the issue in what was almost a throw-away question, when I said:
	Would you like to see any other changes to the Bill?
	Lady Justice Smith responded:
	There is one matter, which you might feel is quite small. [Official Report, Health and Social Care Public Bill Committee, 8 January 2008; c. 37, Q64.]
	It ended up being something that exercised a great deal of time in Committee. I think that that is right, because, as others have pointed outLady Justice Smith has been quoted at lengththere are good reasons why legal chairs could make a difference. The costs bear that out as well. However, I was also quite taken with the Government's argument that a legally qualified chair may not be necessary in every case. What I do not think we teased out in enough detail in Committee is where the bar might be set. The document referred to by the hon. Member for Eddisbury gives costings for 20 per cent., 25 per cent. and 50 per cent.

Stephen O'Brien: But not for 100 per cent.

Sandra Gidley: I am not, as yet, entirely convinced that legal chairs are needed in 100 per cent. of cases. However, I think it a shame that the House's procedures prevent us from voting on both options, and I am fairly sure that the issue will arise again in another place.
	I thank the Minister for listening to all the points that were raised. In Committee he was clearly sympathetic. Amendment No. 23 is unlikely to be put to the vote because there is no opposition to it, but if it had been, I might well have supported it. If the matter returns to us, it would be helpful to be given a little more detail about what might and might not be considered appropriate for a legal chair. I appreciate that to an extent that may be in the hands of the profession and the OHPA, but when we are trying to pass legislation, a lack of clarity about the outcome is not always helpful.
	 Amendment agreed to.
	 Amendments made: No. 24, page 47, line 8 , leave out 'lay members list' and insert
	'list of persons eligible to serve as lay members provided for by section 96(1)(a) (the lay members list)'.
	No. 25, page 47, line 9 , leave out 'professionally qualified members list' and insert
	'list of persons eligible to serve as professionally qualified members provided for by section 96(1)(b) (the professionally qualified members list)'.
	No. 26, page 47, line 14, at end insert
	'(3A) Rules under subsection (3) may in particular make provision requiring the selection in specified circumstances of a chair who is legally qualified for the purposes of section 96(1A)(a), and may provide for pilot schemes under which chairs who are legally qualified for those purposes are, or are not, selected for such proceedings as may be determined in accordance with the rules.'.
	No. 27, page 47, leave out lines 16 to 20.[ Mr. Bradshaw.]

Clause 96
	  
	Lists of persons eligible for membership of fitness to practise panels

Amendments made: No. 28, page 47, line 24, at end insert
	'(aa) persons eligible to serve as chairs,'.
	No. 29, page 47, line 26, at end insert
	'(1A) The list of persons eligible to serve as chairs is to consist of
	(a) persons who are legally qualified,
	(b) persons who are also included on the list of persons eligible to serve as lay members, and
	(c) persons who are also included on the list of persons eligible to serve as professionally qualified members.'.
	No. 30, page 47, line 33, at end insert
	'(3A) Rules made by virtue of subsection (3) must make provision about
	(a) the qualifications which a person must have in order to be legally qualified for the purposes of subsection (1A)(a), and
	(b) the experience which a person must have and the training which a person must have undertaken in order to be eligible for appointment to the list of persons eligible to serve as chairs by virtue of subsection (1A)(b) or (c).'. [Mr. Bradshaw.]

Clause 97
	  
	Further provisions about listed persons

Amendments made: No. 31, page 47, line 39, after 'OHPA', insert '
	(a) '.
	No. 32, page 47, line 40, at end insert ', and
	(b) may pay to any person whom it proposes to include on a list such allowances and expenses as it may determine in connection with the provision of training for the person by virtue of subsection (2)(b).'.
	No. 33, page 47, line 41, after 'OHPA', insert '
	(a) '.
	No. 34, page 47, line 42, at end insert ', and
	(b) may provide, or arrange for the provision of, such training for persons whom it proposes to include on a list as it may determine.'.
	No. 35, page 48, line 5 , leave out 'either' and insert 'any'.  [Mr. Bradshaw.]

Clause 98
	  
	Legal assessors

Amendments made: No. 36, page 48, line 21, after 'make', insert '
	(a) '.
	No. 37, page 48, line 22, at end insert ', and
	(b) provision for a fitness to practise panel not to be advised by a legal assessor if the chair of the panel is legally qualified for the purposes of section 96(1A)(a).'. [Mr. Bradshaw.]

Clause 105
	  
	Fees payable by General Medical Council and General Optical Council

Stephen O'Brien: I beg to move amendment No. 81, page 53, line 3, at end insert
	'(8A) Neither the creation of the regulations under this section nor the payment of any fees under those regulations shall affect the charitable status of a regulatory body.'.

Madam Deputy Speaker: With this it will be convenient to discuss the following: Amendment No. 2, in clause 108, page 53, line 39, at end insert
	'(2A) In section 25 of the 2002 Act, in subsection (2), after paragraph (d) insert
	(e) to promote the provision of independent advice to members of the public in respect of the reporting of concerns to any of the bodies listed in subsection (3).'.
	Government amendments Nos. 38 to 61.

Stephen O'Brien: As I am sure the House knows, the General Medical Council is a registered charity. Over time, other health regulators that may also be charities will come under the auspices of the OHPA, and will be required to pay a fee to that body. All registered charities have duties in relation to how they spend their income, and the GMC and other regulators are no exception, but the Bill contains provisions that directly affect the way in which the GMC should spend a significant proportion of its income, while leaving it little if any discretion in respect of how it does so.
	Given that the OHPA's duties will mirror functions that already sit within the charitable body, the funding of a non-departmental public body such as the OHPAwhose purpose is to uphold the standards of a health professionis clearly unlikely to fall outside the charitable remit. However, it would seem wrong to place a burden on the GMC or another regulator that might have the potential to jeopardise its charitable status without making it clear that that was not Parliament's intention.

Jim Devine: As one who worked in the health service and had to deal with the GMC, I am astonished by the hon. Gentleman's argument. Surely he is not suggesting that, after Shipman, we should not change the rules.

Stephen O'Brien: I am not sure how closely the hon. Gentleman has been following the debate. He ought to know that, as has been repeatedly put on record, we have strongly supported a change in the rules. I am a little perplexed about how the question could even have entered his mind, but perhaps he has not been able to follow the Bill's progress as closely as his question might have merited. We have not voted against the Bill, and we welcome the changes. What I am talking about is charitable status, which I hope is deeply important to the hon. Gentleman. If the GMC is not a charitable body, there will be a series of consequences.
	Let me proceed with my argument. It may help to clarify any confusion that may have arisen in the hon. Gentleman's mind. The Government may argue that we should not bind the hands of the Charity Commission, a body that operates independently of Ministers, but there are clear precedents for such action in other legislation. For example, further and higher education corporations are designated charities under section 41 of the Teaching and Higher Education Act 1998, and common investment funds are classed as charities under section 24 of the Charities Act 1993. Amendment No. 81 is intended to prevent the operation of fees from introducing any ambiguity into the designation of the GMC as a registered charity.
	As the Liberal Democrats tabled amendment No. 2, it will be for a Liberal Democrat Member to speak to it. The others are Government amendments. While most of them appear to be tidying-up measures, amendment No. 48 appears to disqualify hon. Members from sitting on OHPA adjudication panels. I do not believe that involvement with the GMC is prohibited by membership of the House of Commons, and I should be grateful if the Minister could explain what changes the Government intend. If the answer is not satisfactory, I dare say that the matter will be pursued in another place, but, as the Minister must be aware, some Members are currently involved in the adjudication processes of the GMC.
	We also need to tackle the issue of the costs of the OHPA. I thank the Minister for furnishing us with the report on the costs that we had requested, although I was disappointed that we did not receive it before the Committee stage. I hope that he will be able to provide the independent report by financial advisers engaged by the GMC, which was supposed to be available at the end of January and which is mentioned in column 365 of the record of our Committee proceedings.
	The Government report divides the costs into three groups: set-up and transition costs for the GMC, other costs to be paid by the Department, and adjudication and running costs. The set-up costs, the Government finally reveal, will be about 3 million to 4 million over two years, but they are to be further refined. The other costs, such as those of High Court referrals or big cases, have not been estimated, and I should be grateful if the Minister could identify the nature of that liability. The adjudication costs are not expected to exceed the current GMC costs of around 11.5 million. The running costs are not identified, which is odd, but the paper does identify a probable increase of between 20 and 30 per registrant per year. That would increase the General Medical Council registration to more than 400 and that of the General Optical Council to almost 200. A full GMC registration on the medical register is to rise to 390 a year with effect from April this year, having been frozen at 290 since 2002, and GOC registration stands at 169 per annum. It also suggests running costs for the OHPA of about 6 million per annumI hope that the Minister will be able to confirm that figure.
	We remain deeply unsatisfied about the independence of the OHPA. We have searched Government amendments for where the Minister might give assurances about the independence of its decision making, but as the organisation is created the Department will needlessly still have its hands all over its finances. That is neither necessary nor desirable. Concerns remain over the civil standard of proof, which we discussed earlier and the Government failed to address. We were also looking for permanent legally qualified chairs, but we have now assented to a different situation.
	The Government must recognise that as the Bill progresses a full response is required on professional regulation and the impact that the practice of defensive medicine might have on our NHS, particularly financiallyI hope there will be time to provide that when the Bill is considered in another place. I am sure that the Minister recalls that this was one of the areas of greatest contention during oral evidence sessions, and I think all Members were concerned about the BMA presenting the idea that the new regime would create over-defensiveness. I do not wish to be too criticalthose giving that evidence must have thought that they were making representations on behalf of their membersbut we need to bottom out what has been expressed on behalf of doctors about the impact of what is going on in terms of defensive medicine because we do not want that, and I do not believe it is likely to be a trend or a consequence; I would not be able to support the Bill if I did. Although I do not believe that to be the case, it is important to take such representations seriously and address them, rather than simply dismiss them out of hand. If necessary, we might have to appeal, through the BMA, to make sure that doctors are reassured that they need not be over-concerned about that. I have been getting the impression that the Minister might feel that that is a worthwhile point, which is good.
	The Government amendments on professional regulation would give the power through secondary legislation to impose a lay majority on the regulatory bodies. The GMC has been arguing for parity, and that makes sense for the confidence of both the public and the profession. I dare say that that will be pursued in another place.
	I have spoken to amendment No. 81 and I have addressed the other issues that arise. If the Minister does not provide a satisfactory response on the charitable status of the GMC, I might need to press the amendment to a Division.

Sandra Gidley: I shall start by speaking to Liberal Democrat amendment No. 2, which would make it a duty of the Council for Healthcare Regulatory Excellence to commission independent advice and information services to assist members of the public who have concerns about the fitness to practise of a health professional. One decision that might have to be made would be whether to report a concern to a regulatory body. If the decision was to go ahead with that, there would be a duty to provide help in reporting the concerns in an effective way, and if the matter were dealt with by the OHPA there would be a duty to support the member of the public through the process.
	There is currently no service to inform members of the public of where to report concerns about health professionals or to help them do so. That is a great problem. Let us take the Shipman case as an example. The people who were directly affected by Shipman were not in a position to complain, but his mode of operation might have been slightly different and those who might have had concerns because they felt they were being targeted in some way would have been members of one of the most vulnerable groups in society. Many people who have reached the age of 60 do have the time and ability to deal with such things, but some of them, especially if they are not well and life is a bit of an effort, find it difficult to discover in our complicated society where they should go to get the help they need. There is therefore a feeling that many problems are not brought forward because people do not know how to do that; advice is patchy, and no support is available.
	Many stakeholders believe that this need should be met. There would have to be a cap on the system because we would not want there to be an open invitation for everybody to take advice, but provided that certain criteria are met this could provide a useful way of enabling people who would not otherwise bring complaints to bring them early, so that problems are nipped in the bud. This duty would be compatible with the CHRE's overall duty to serve patients and the public and promote excellence in health professional regulators.
	On amendment No. 81, I was somewhat surprised when I discovered that the GMC was a registered charity. I am not sure why a professional regulatory body should have that status, and I am interested to know what charitable works it performs, although that is a side issue. I have listened carefully to the comments of the hon. Member for Eddisbury (Mr. O'Brien), and I could not understand how the creation of fees would definitely have an effect on the charitable status of the regulatory body.

Stephen O'Brien: It may be helpful if I clarify that there are precedents elsewhere whereby, when a fee is exchanged of a substantial amount of a body's income, it is effectively a cost recovery or could even be regarded as a professional commercial transaction, because fees are paid for membership. It has not necessarily been as clear as it might have been that a body in that position can retain charitable status. In the case of other bodies, it has been felt necessary to specify that in the relevant legislation, to ensure that there is no danger to their charitable status. I feel that the GMC deserves to have equal assurance and equal respect paid to it.

Sandra Gidley: I thank the hon. Gentleman for that clarification. I am not entirely sure whether the amendment is necessary, so I shall listen to the Minister's comments with interest.
	The bulk of the amendments seem to be tidying-up amendments to a certain degree, and I have no problems with any of them, so I shall not detain the House any longer.

Ben Bradshaw: Amendment No. 81 would provide that neither the making of fees regulations by the Secretary of State nor the payment of a fee to OHPA would affect the charitable status of the regulatory body. I hope to be able to reassure the hon. Member for Eddisbury (Mr. O'Brien). I can go into detail about what justifies the GMC's charitable status if the hon. Member for Romsey (Sandra Gidley) really wants me to, but perhaps I had better write to her. We are advised that it will not be affected. My officials have been in contact with the Charity Commission, which has indicated that the key issue is a body's charitable purpose. A requirement in law to make a payment to another body would not of itself cause a body to lose its charitable status, although it could be a relevant factor in assessing its purpose and whether it is for public benefit. I am pleased to confirm that the Charity Commission's initial view is that
	the proposed changes will not mean that the GMC is no longer in law a charity.
	Amendment No. 2 would insert a new statutory function of the CHRE into section 25(2) of the National Health Service Reform and Health Care Professions Act 2002, through clause 108. The proposed new function is to promote the provision of independent advice to the public on reporting concerns to the regulatory bodies. We fully accept the reasoning behind the amendment tabled by the hon. Member for Romsey, but we do not believe that it is necessary.
	Clause 108 already inserts into section 25 of the 2002 Act a new main objective that the CHRE must consider when exercising its functions: how it will promote the health, safety and well-being of patients and other members of the public. That will allow the CHRE to promote and provide independent advice along the lines suggested in amendment No. 2, and to encompass the sentiment behind the amendment. We do not want to be too prescriptive regarding how the CHRE should carry out that objective, because it is important that it work in consultation with patients and the public to determine how best it can achieve it. It has already begun a programme of work that will lead to the implementation of a patient and public strategy aimed at ensuring that it can fulfil the proposed function of becoming an authoritative voice for patients.
	In Committee, I confirmed that our reform of the CHRE was intended to ensure that it fits with the new regulatory landscape, including by shifting its role to that of being the independent voice of the patient. I believe that our proposals meet that objective. On that basis, I hope that the hon. Lady will not press the amendment.

Brian Jenkins: I recognise what my hon. Friend the Minister says, but I also recognise the concern of the hon. Member for Romsey (Sandra Gidley). Although we have feedback about the group of patients involved and the provision for them, what can my hon. Friend say about the individual patient who, although not alarmed enough to make a formal complaint, feels alarmed enough to feed their concerns into the system? Will he ensure that there is a mechanism to allow the individual patient to do that, and that if enough individual patients feed in their concerns about a health professional, inquiries can be made into that professional's conduct?

Ben Bradshaw: There are already mechanisms in place, as I am sure my hon. Friend would acknowledge, and it is important that they are sustained. I would encourage all patients and members of the public who have complaints to make to inform themselves of the formal complaints procedure and, if necessary, to escalate that. I also think that more could be done by health care providers to advertise and publicise the existence of complaints procedures. All too often, people are still not aware of their right to complain, where to go or how to escalate their complaints. The new Care Quality Commission and the other independent bodies that we are establishing in the Bill will need to address that as a priority. I hope that that reassures my hon. Friend.
	Government amendments Nos. 38 to 61 are, as has been acknowledged, technical and consequential on the changes that we are making to the CHRE and to the OHPA. I am grateful to the hon. Member for Eddisbury for his question on amendment No. 48, because clarification may be necessary. The intention behind the amendment is not to prevent Members of this House from serving on the GMC, and nor is that a result of it, but it would prevent them from serving on the OHPA. I undertake to clarify the issue and respond to the hon. Gentleman. If necessary, it will be addressed in the other place.

Jim Devine: Will my hon. Friend meet me and members of the Nursing and Midwifery Council who are concerned about the structure of that body? It appears to be very racist and to employ a bullying strategy.

Ben Bradshaw: I am always happy to meet hon. Members. We may be able to discuss the issue informally shortly, and I hope that I will be able to reassure him. I have now concluded my remarks.

Stephen O'Brien: I have listened carefully to the Minister and if there is any residual lack of clarity in the way that I raised the issue of Government amendment No. 48, I suspect that it would be helpful to those who will consider this in the other place to be aware of the intention behind it. If the drafting needs perfecting, I am sure that the other place will have an opportunity to do so. I was baffled by the point raised by the hon. Member for Livingston (Mr. Devine) in an intervention.
	Amendment No. 81 is the lead amendment and amendment No. 2, tabled by the Liberal Democrats, rides with it, so I think I am right in saying that it will not cause a problem if I seek to withdraw it. The Minister went out of his way to try to give me the assurance that I was seeking in relation to the continuing charitable status of the GMC. I heard him say in terms and on the record that that was what was expected and, above all, was the advice that he had been given. I had suggested that we might need to divide the House, but in the light of that assurance I am happy not to do so. I beg to ask leave to withdraw the amendment.
	 Amendment, by leave, withdrawn.

Clause 110
	  
	Powers and duties of Council

Amendments made: No. 38, page 55, line 12, leave out 'taking action under section 29' and insert
	'where section 29 applies, taking action under that section'.
	No. 39, page 55, line 16 , after 'recommendations', insert 'to the regulatory body'. [Mr. Watts.]

Schedule 3
	  
	Amendments of Mental Health Act 1983

Amendment made: No. 68, page 118, line 13, at end insert
	'( ) In subsection (6), for section 121(7) and (8) above substitute section 134A(1) to (4).'. [Mr. Watts.]

Schedule 5
	  
	Further amendments relating to Part 1

Amendments made: No. 69, page 136, line 13, at end insert
	 'Audit Commission Act 1998 (c. 18)
	63A (1) Section 4 of the Audit Commission Act 1998 (code of audit practice) is amended as follows.
	(2) In subsection (7)
	(a) in paragraph (a) omit the Commission for Healthcare Audit and Inspection and,
	(b) in paragraph (b) omit the Commission for Social Care Inspection and, and
	(c) in paragraph (c) before and such bodies insert , the Care Quality Commission.
	(3) In subsection (8), for the Commission for Healthcare Audit and Inspection substitute the Care Quality Commission.
	63B (1) Section 7 of the Audit Commission Act 1998 (fees) is amended as follows.
	(2) In subsection (2)
	(a) in paragraph (a) for the Commission for Healthcare Audit and Inspection and such other substitute such, and
	(b) in paragraph (c) before such bodies insert the Care Quality Commission and.
	(3) In subsection (9) for paragraph (aa) substitute
	(aa) the Care Quality Commission,.
	63C (1) In section 33 of the Audit Commission Act 1998 (studies for improving economy etc in services), subsection (6) is amended as follows.
	(2) In paragraph (c), for the Commission for Healthcare Audit and Inspection substitute the Care Quality Commission.
	(3) For paragraph (d) substitute
	(d) in the case of a study which has a connection with adult social services (within the meaning of Part 1 of the Health and Social Care Act 2008), also consult the Care Quality Commission; and.
	(4) In paragraph (e) for that Part of that Act substitute Part 2 of the Health and Social Care (Community Health and Standards) Act 2003.
	63D (1) In section 34 of the Audit Commission Act 1998 (reports on impact of statutory provisions), subsection (6) is amended as follows.
	(2) For paragraph (ba) substitute
	(ba) in the case of a study which has a connection with adult social services (within the meaning of Part 1 of the Health and Social Care Act 2008), the Care Quality Commission;.
	(3) In paragraph (bb) for that Part of that Act substitute Part 2 of the Health and Social Care (Community Health and Standards) Act 2003.
	63E (1) In section 49 of the Audit Commission Act 1998 (disclosure), subsection (1) is amended as follows.
	(2) Omit paragraph (ba).
	(3) In paragraph (bb), for that Part of that Act substitute Part 2 of the Health and Social Care (Community Health and Standards) Act 2003.
	(4) In paragraph (c) omit the words from or for the purposes of the functions of the Commission to the end.
	(5) After paragraph (ca) insert
	(cb) for the purposes of the functions of the Care Quality Commission under Part 1 of the Health and Social Care Act 2008;.
	63F In Schedule 2A to the Audit Commission Act 1998 (interaction with other authorities), in paragraph 1(1)
	(a) at the end of paragraph (f) insert the word or,
	(b) omit paragraph (g) (together with the word or at the end of it), and
	(c) for paragraph (h) substitute
	(h) the Care Quality Commission.'.
	No. 70, page 137, line 28, at end insert
	 'Children Act 2004 (c. 31)
	In section 20 of the Children Act 2004 (joint area reviews), in subsection (4), for paragraph (d) substitute
	(d) the Care Quality Commission;.'.
	No. 71, page 138, line 5, at end insert
	 'National Health Service Act 2006 (c. 41)
	71A In section 9 of the National Health Service Act 2006 (NHS contracts), in subsection (4), for paragraph (k) substitute
	(k) the Care Quality Commission,.
	71B In section 35 of the National Health Service Act 2006 (authorisation of NHS foundation trusts), in subsection (3)(a), for the Commission for Healthcare Audit and Inspection substitute the Care Quality Commission.
	71C In section 56 of the National Health Service Act 2006 (mergers), in subsection (6)(a), for the Commission for Healthcare Audit and Inspection substitute the Care Quality Commission.
	72D In section 71 of the National Health Service Act 2006 (schemes for meeting losses and liabilities etc of certain health service bodies), in subsection (2)(f), for the Commission for Healthcare Audit and Inspection substitute the Care Quality Commission.
	71E In Schedule 10 to the National Health Service Act 2006 (audit of accounts of NHS foundation trusts), in paragraph 8(1)(e), for the words from the Commission to the end substitute the Care Quality Commission.
	 National Health Service (Wales) Act 2006 (c. 42)
	71F In section 7 of the National Health Service (Wales) Act 2006 (NHS contracts), in subsection (4), for paragraph (k) substitute
	(k) the Care Quality Commission,.
	71G In section 30 of the National Health Service (Wales) Act 2006 (schemes for meeting losses and liabilities etc of certain health service bodies), in subsection (2)
	(a) at the end of paragraph (c) insert and, and
	(b) omit paragraph (d) (together with the word and at the end of it).'.
	No. 72, page 138, line 12, at end insert
	 'Safeguarding Vulnerable Groups Act 2006 (c. 47)
	73A In section 45 of the Safeguarding Vulnerable Groups Act 2006 (supervisory authorities: duty to refer), in subsection (7)
	(a) for paragraph (c) substitute
	(c) the Care Quality Commission in respect of its functions under Part 1 of the Health and Social Care Act 2008;,
	(b) omit paragraph (d), and
	(c) in paragraph (e), for that Act substitute the Health and Social Care (Community Health and Standards) Act 2003.
	73B (1) Paragraph 1 of Schedule 4 to the Safeguarding Vulnerable Groups Act 2006 (regulated activity relating to children) is amended as follows.
	(2) In sub-paragraph (10)
	(a) for paragraph (e) substitute
	(e) the Care Quality Commission;, and
	(b) omit paragraph (f).
	(3) In sub-paragraph (11), omit paragraph (a).
	(4) After sub-paragraph (13) insert
	(13A) The exercise of a function of the Care Quality Commission so far as the function relates to the inspection of anything which
	(a) is listed in section 56(1) of the Health and Social Care Act 2008, and
	(b) involves the provision of any form of treatment or therapy for children,
	is a regulated activity relating to children.
	(5) In sub-paragraph (14), for or (11) substitute , (11) or (13A).'.
	73C (1) Paragraph 7 of Schedule 4 to the Safeguarding Vulnerable Groups Act 2006 (regulated activity relating to vulnerable adults) is amended as follows.
	(2) In sub-paragraph (6), omit paragraphs (a) and (b).
	(3) After sub-paragraph (8) insert
	(8A) The exercise of a function of the Care Quality Commission so far as the function relates to the inspection of anything which
	(a) is listed in section 56(1) of the Health and Social Care Act 2008, and
	(b) involves the provision of social services, care, treatment or therapy for vulnerable adults,
	is a regulated activity relating to vulnerable adults.'. [Mr. Watts.]

Schedule 6
	  
	The Office of the Health Professions Adjudicator

Amendments made: No. 40, page 142, line 24, at end insert
	 'Meetings of the OHPA in Northern Ireland
	(4) Sections 23 to 27 of the Local Government Act (Northern Ireland) 1972 (c. 9) (which provide for public access to meetings of a district council, the publication of information concerning such meetings etc.) apply in relation to meetings of the OHPA in Northern Ireland as they apply in relation to meetings of a district council but subject to the following modifications.
	(5) The modifications are that
	(a) any reference to a district council is to be read as a reference to the OHPA, and
	(b) any reference to councillors or members of the council is to be read as a reference to members of the OHPA.'.  [Mr. Watts.]

Schedule 7
	  
	Adjudication functions under Medical Act 1983 and Opticians Act 1989

Amendments made: No. 41, page 148, line 5, at end insert
	'(5A) Omit subsection (8).' . [Mr. Watts.]

Schedule 10
	  
	Further amendments relating to part 2

Amendments made: No. 42, page 167, line 33, after first 'in', insert 'Part 2 of'.
	No. 43, page 167, line 33, after 'Schedule', insert '
	(a) '.
	No. 44, page 167, line 35, at end insert ', and
	(b) at the appropriate place insert
	The Office of the Health Professions Adjudicator.'.
	No. 45, page 167, line 38, leave out from beginning to 'for' and insert '
	(a) in paragraph 1 (bodies to which in England and Wales Act applies),'.
	No. 46, page 167, line 41, after 'Excellence', insert ';
	(bcb) the Office of the Health Professions Adjudicator;, and
	(b) in paragraph 2 (bodies to which in Scotland Act applies), before paragraph (d) insert
	(ca) the Council for Healthcare Regulatory Excellence;
	(cb) the Office of the Health Professions Adjudicator;.'.
	No. 47, page 168, line 3, after 'disqualified)', insert '
	(a) '.
	No. 48, page 168, line 5, at end insert ', and
	(b) at the appropriate place insert
	The Office of the Health Professions Adjudicator.'.
	No. 49, page 168, line 8, after 'disqualified)', insert '
	(a) '.
	No. 50, page 168, line 10, at end insert ', and
	(b) at the appropriate place insert
	The Office of the Health Professions Adjudicator.'.
	No. 51, page 168, line 12, leave out 'Part 3 of'.
	No. 52, page 168, line 13, after 'duty)', insert '
	(a) in Part 2, at the appropriate place under the heading Health insert
	The Office of the Health Professions Adjudicator., and
	(b) in Part 3,'.
	No. 53, page 168, line 16, at end insert
	' In section 27 of the Dentists Act 1984 (allegations against registered dentists), in subsection (2)(g), after social care profession insert , or by the Office of the Health Professions Adjudicator,.'.
	No. 54, page 168, line 20, at end insert
	' In section 36N of the Dentists Act 1984 (allegations against registered dental care professionals), in subsection (2)(g), after social care profession insert , or by the Office of the Health Professions Adjudicator,.'.
	No. 55, page 169, line 16, after 'authorities)', insert '
	(a) '.
	No. 56, page 169, line 18, at end insert ', and
	(b) at the appropriate place insert
	The Office of the Health Professions Adjudicator.'.
	No. 57, page 169, line 18, at end insert
	 'Nursing and Midwifery Order 2001 (S.I. 2002/253)
	In article 22 of the Nursing and Midwifery Order 2001 (allegations), in paragraph (1)(a)(v), after social care profession insert , or by the Office of the Health Professions Adjudicator,.'.
	No. 58, page 169, line 18, at end insert
	 'Health Professions Order 2001 (S.I. 2002/254)
	In article 22 of the Health Professions Order 2001 (allegations), in paragraph (1)(a)(v), after social care profession insert , or by the Office of the Health Professions Adjudicator,.'.
	No. 59, page 170, line 34, at end insert
	 'Pharmacists and Pharmacy Technicians Order 2007 (S.I. 2007/289)
	In article 48 of the Pharmacists and Pharmacy Technicians Order 2007 (impairment of fitness to practise), in paragraph (1)(k), after social care profession insert , or by the Office of the Health Professions Adjudicator,.' . [Mr. Watts.]

Schedule 15
	  
	Repeals and revocations

Amendments made: No. 73, page 188, line 39, at end insert
	
		
			 'Audit Commission Act 1998 (c. 18) In section 4(7) 
			  (a) in paragraph (a), the words the Commission for Healthcare Audit and Inspection and, and 
			  (b) in paragraph (b), the words the Commission for Social Care Inspection and. 
			  In section 49(1) 
			  (a) paragraph (ba), and 
			  (b) in paragraph (c), the words from or for the purposes of the functions of the Commission to the end. 
			  In Schedule 2A, paragraph 1(1)(g) (together with the word or at the end of it).'. 
		
	
	No. 74, page 189, line 44, at end insert
	
		
			 'National Health Service (Wales) Act 2006 In section 30(2), paragraph (d) (together with the word and at the end of that paragraph). 
			 Safeguarding Vulnerable Groups Act 2006 (c. 47) Section 45(7)(d). 
			  In Schedule 4 
			  (a) paragraph 1(10)(f), 
			  (b) paragraph 1(11)(a), and 
			  (c) paragraph 7(6)(a) and (b).'. 
		
	
	No. 60, page 190, line 2, column 2, leave out '(7),' and insert '
	
		
			  (a) in subsection (7),'. 
		
	
	No. 61, page 190, line 4, column 2, at end insert ', and
	
		
			  (b) subsection (8).'. [Mr. Watts.] 
		
	
	 Order for Third Reading read.

Ben Bradshaw: I beg to move, That the Bill be now read the Third time.
	I would like to begin by thanking hon. Members for their contributions in scrutinising and improving this Bill both in Committee and on the Floor of the House today. I think that the Bill benefited from the evidence-giving processa young but positive reform of the procedures of this House.
	We are not here discussing one of the more controversial or hotly politically contested Bills. In fact, our deliberations have shown a broad consensus of support for the main provisions of the Billthe integration of the way we regulate health, including mental health and social care, and the modernisation of the way we regulate the medical professions. Central to this Bill is the aim of assuring safety and quality of care for all patients and service users.
	The establishment of a new independent, integrated regulator with enhanced powers to succeed the three existing bodiesthe new Care Quality Commissionis both timely and right. Patients and service users expect a comprehensive and seamless system of regulation that focuses on the quality and safety of services, rather than their setting.
	The Care Quality Commission will bring several improvements. First, it will bring a joined-up system of regulation for health and adult social care, and I emphasise the importance that we expect the new regulator to place on both areas. That joined-up approach has been welcomed by both sides of the House. Secondly, it will extend regulation to the provision of NHS services for the first time ever. Thirdly, the set of new enforcement and sanction powers, which were again broadly welcomed from both sides of the House, will enable the new commission to deal with unsafe practices, such as poor standards of cleanliness and hygiene. Finally, the commission will allow a flexible and proportionate approach to regulation. The Mental Health Act Commission's existing functions will be set, with some enhancement of the core of the new regulator's work. All hon. Members who have spoken have stressed the importance of the regulator's freedom to carry out its functions in the way that it sees fit, through arrangements that encourage its independence.
	During our discussions on the Care Quality Commission we listened to the views expressed by Members on both sides of the House and, as we discussed earlier, we made a number of changes. We have clarified that the Care Quality Commission must have regard to those who represent the views of the public. We also listened to the points raised by the hon. Member for Romsey (Sandra Gidley), among others, about the need for the commission to publish its reports. That has always been the Government's intention, but we are happy to have put that beyond doubt by clarifying it further on the face of the Bill.
	As I mentioned earlier, we also intend to address the issue of the application of the Human Rights Act 1998 to health and social care when the Bill reaches the other place. On the regulation of health and social care professions, we have also listened carefully to the representations made, not least to those made by Lady Justice Smith, whose original reports on the Shipman murders helped to inform many of the changes that the Bill will bring about. We have tabled and agreed an amendment just now on the issue of legally qualified chairs for hearings of the new independent adjudicator.
	Of course, we fully scrutinised the parts of the Bill that we have not discussed today in Committee, including the health protection elements and the health in pregnancy grant. I am sure that those issues will be scrutinised carefully in another place.
	By reforming health and social care regulation, and by introducing tough new sanctions as well as reforming professional regulation, the Bill puts safety and quality at the heart of the health and social care system. I commend it to the House.

Stephen O'Brien: This portmanteau Bill is incredibly wide ranging in content and it leaves vast amounts to secondary legislationboth things cause concern to the House in terms of proper parliamentary scrutiny. We have debated only a fraction of the outstanding issues this afternoon, and no doubt further clarification will be sought on a number of points in another place. However, as the Minister rightly observed, the broad thrust of the Bill is right, even if it is not necessarily timely. That makes getting the detail correct even more important.
	We have sought many improvements, and we will no doubt seek more as the Bill goes on its way. We were grateful for the 12 sittings in Committee, which included some long sittings in order to bring proceedings to a close. We were able to time that almost to the minute so that both sides felt that the Committee had offered adequate consideration. That was the first time that I have been involved in a Committee of which that could be said.
	It was disappointing that the Government did not accept our full witness list for oral evidence, but both sides of the House will agree that that was a useful procedure for the Committee. I dare say that the model will be looked at furtherit is yet to be perfected. It is important that the witness list is not just a list of the Government's biddingit was not in our case.
	I pay tribute to my colleagues in the Committee, and not only to those on the Front Bench. My hon. Friend the Member for Guildford (Anne Milton) guided us through many parts of the Bill during the Committee. Those on the Benches behind me, including my hon. Friend the Member for Tiverton and Honiton (Angela Browning)[Hon. Members: Where are they?] My hon. Friends might not have expected Third Reading to begin at this hour and are not yet in their places, but they have certainly been in evidence for a great deal of the debate and have added a great deal of thought and sensitivity to our deliberations.
	It was important to have the presence of my hon. Friend the Member for Preseli Pembrokeshire (Mr. Crabb) in Committee. Despite the Bill's significant ramifications for the devolved Administrations, he was the only MP in the Committee whose seat is in a devolved Administration. I also pay tribute to the way in which the Committee was chaired and to all the Clerks.
	We have won two important Government concessions. We are grateful for the fact that the Minister has if not bowed, then at least nodded to the force of our arguments on, first, the inclusion of a strong patient voice in the CQC. Despite our best efforts, the Government will not include LINkslocal involvement networksin the Bill. No doubt such efforts will continue in another place, and we urge the Government to reconsider. We are also glad that there is now scope for legally qualified chairs and that they will be piloted. However, we remain concerned, particularly given the application of the civil standard of proof, that their role should be universal. Again, I am sure that that debate will be continued in another place.
	We have not been able to change the Government's mind on a number of issues. Obviously those issues will be pursued, particularly those that I raised earlier on Report in relation to HealthWatch. A clear function is required for the CQC, particularly given the concerns about its proposed governance structure. That is not merely a cosmetic legislative issue. The House has an opportunityindeed, I think that it has an obligationto send a very clear message to the new commission about what the House expects it to achieve, particularly given, as was agreed, the achievements of the bodies that it will succeed and especially as they were just getting into their stride in a way that was adding value.
	Independence and the complaints process remain concerns, as do the reviews and the general ability to give opinions on the basis of the evidence that has been gained and on the basis that visits must be properly maintained, particularly in relation to those who are detained under the mental health Acts.
	We have had useful debates on the extent to which human rights and a rights-based approach should be at the core of health and social care in particular. Again, such debates will continue, as will the discussion of malnutrition and the extent of professional regulation, which we have only just discussed.
	Public health measures have not featured in today's discussions, although they have been scrutinised with care and determination by my hon. Friend the Member for Guildford. That needs to be placed on record. Although we broadly welcome such measures towards appropriate legislation to deal with modern-day contingencies, we and others, including the organisation Liberty, remain concerned about the length and reporting of detention under such powers. We hope that the Government will introduce in another place the relevant draft regulations and examples of instances where such legislation might be necessary and that there will be an opportunity to discuss the amendments that we were unable to touch on today. The Government may well want to reflect on those issues, and we might need to consider them again if they come back as Lords amendments, even Government Lords amendments.
	The health in pregnancy grant is another area that we have not touched on today. It is therefore appropriate to use Third Reading to highlight the grant, which was discussed at length in Committee. It is an important part of the Bill. Indeed, the Government have made much of what they are seeking to do with the health in pregnancy grant. Unfortunately, although we used an extensive series of arguments, backed by evidence, we never managed to get the Government to accept that there was a better way to approach the benefits that are sought with the grant. Ours is a different way from that proposed by the Government. I encourage hon. Members to read column 455 of the report of the proceedings in Committee. Quite rightly, it would be inappropriate to repeat those arguments now, but the Government need to put more thought into the grant, because the evidence base does not support what the Prime Minister and the Government are pursuing.
	Most telling was the Minister's admission that the nutritional benefits of a cash payment are better in early pregnancywe entirely agree with that, of coursealthough the Prime Minister, then the Chancellor, announced at the outset that support was needed in the last months of pregnancy, on the basis that nutrition is most important then. Not only was the Prime Minister wrong, but answers to parliamentary questions suggest that the Minister was initially wrong as well. The change made during the proceedings in Committee was a fair reflection of the evidence. All of us who have looked at the issue carefullyparticularly women, who are the ones most affected by such issuesrecognise that, when focused on the health of the to-be-born child, the most important time for nutrition to be right is both pre-conception and in the early weeks and months of pregnancy, more than in the last weeks, as the Prime Minister suggested.
	The Bill includes a huge number of miscellaneous provisions and refers to much secondary legislation. However, it has received worthwhile scrutiny, and Parliament has done the job that it must do by seeking to improve the Bill and to elucidate what lies behind it so that the right pointers are given on how further scrutiny can take place with the wisdom that those in another place can bring to bear. I hope that many of our debates will flag up the areas on which those preparing for such scrutiny will need to focus their attention. I also hope that the arguments that we have tried to make will help their deliberations.
	I thank those who served on the Public Bill Committee, especially my Conservative colleagues and my hon. Friend the Member for Guildford. Although this is not very usual, I pay tribute to those in our research offices who do a lot of work in the background and are often unsung. It is important that we in opposition are supported, given that we must contend with the fact that the Minister is rightly supported by a full Department. I thus pay tribute to the researcher who has helped my hon. Friend and to Sam Barker, who has been a tremendous help to me during the passage of the Bill.

David Taylor: I apologise for not being in the Chamber for about a minute at the start of the debate. We moved on to Third Reading rather more speedily than most people had expected.
	Public trust is central to rebuilding public confidence in our system of professional health regulation. However, the way in which the Department of Health has gone about addressing that challenge in the past two years has sometimes had the opposite effect. My contribution on Second Reading and the amendments tabled to clauses 105, 106 and 108 were designed to support the capacity of the Council for Healthcare Regulatory Excellence's to be, in the words of the White Paper, a truly
	authoritative independent voice for patients on the regulation of professionals, providing expert advice on policy.
	To date, the Government have neglected an important opportunity to renew democratic accountability, perhaps in their desperation to retain central control.
	At the citizens councils meeting that I organised in Committee Room 17 on 8 January 2008, underlying a great many issues raised by informed patients and public members, on which reassurance is sought, were five themes that are particularly relevant to the aspirations set out in the original White Paper. I wrote to the Minister about these matters on 6 February and I will no doubt hear from him.
	First, astonishingly, the CHRE is yet to agree a patient and public involvement strategy. How will the patient and public arrangements that it puts in place be sufficiently independent and at arm's length from the Government, regulators and the CHRE itself to provide an assurance that the real concerns of informed patients will be addressed?
	Secondly, will the process be sufficiently well resourced to cut through often complex technical jargon so that participants are informed and have a capacity to develop a patient-centred position? Thirdly, how will the CHRE's PPI arrangements enhance existing public and patient engagement strategies in Scotland, England, Wales and Northern Ireland with a commitment that they will actively facilitate communication among representatives from each country, respect the differences and similarities between each country, and be tailored to meet their specific needs?
	Fourthly, we know that the number of the oldest and most vulnerable people requiring care will inevitably increase substantially. What assurances have the Government sought and received from the CHRE that it will be able to ensure that such vulnerable groups are identified and that specific measures are put in place to address their needs?
	Fifthly, what further systems of parliamentary accountability will the CHRE and the regulators be subject to if the Bill is passed in its current form? If there is a Division on Third Reading, I shall vote for the Bill. I voted against amendment No. 131, to which I put my name, because I accepted the Government's reassurances. However, if we are to have a Standing Committee, why is it to be of both Houses of Parliament? What is meant by oversee? Does the Minister agree that there is a need for innovative techniques to ensure that the public and patient voice is heard in the process?
	Sixthly, is the Minister aware of the implications of the CHRE not putting in place an effective PPI strategyincluding independent arrangements and practical support to ensure that a strong patient voice is heardthat will command public confidence and the support of the devolved Administrations in Scotland, Wales and Northern Ireland? The proposed CHRE membership is far too small for the council effectively to reflect the diversity and breadth of views in a sector employing 2 million people and stretching across four countries. In the Bill, officials propose an inappropriate NHS trust-type model, which will have insufficient members to ensure a clear distinction between remuneration and audit committee functions. That is why it is disappointing that the Minister did not respond positively to the amendments to clause 106 tabled in Committee by my hon. Friend the Member for Luton, North (Kelvin Hopkins).
	Will the two CHRE executives allowed to be non-executive council members of the public body be a truly
	authoritative independent voice for patients on the regulation of professionals, providing expert advice on policy,
	when all CHRE executives already speak at council meetings? Why has the White Paper implementation website been such a calamity, preventing anyone outside a magic, private policy circle from contributing to debates preparing us for discussions such as this one, despite the promise of inclusivity given at the national White Paper implementation advisory conference on 5 June last year?
	The lack of urgency means that work streams have made very little progress, giving the impression that they are window dressing while real decisions are being taken elsewhere. How can Parliament debate health regulatory corporate governance issues properly when the internal report sent to Ministers in November last year is unavailable for this debate? If the report proposed a Standing Committee of both Houses of Parliament, why are we being denied the opportunity properly to scrutinise that recommendation?
	Does the Minister agree that it is no longer good enough to continue to define lay as not on our register? If so, what changes are required in the criteria to be used in appointing new lay and public members to the regulatory bodies and the CHRE, and when will Parliament and the wider public be able to comment on such criteria before the Appointments Commission adopts them? Why are lay and public members expected to reflect a wider perspective across the four countries, rather than representing the interests of patients and the public?
	It is a well-intended Bill, no doubt, and it will tackle some of the concerns that were well debated in CommitteeI attended some sittings, as well as Second Reading and tonight's debatewith a degree of competence and professionalism, but I shall back the Bill and go through the Lobby, if there is a Division on Third Reading, without significant enthusiasm. I believe that in the Labour Government's fourth term, in two and a half or three years' time, another Minister will be back to tackle the matter yet again with community health councils, mark 4. I do not think that the Bill is the way ahead. An opportunity has been missed. Although the Minister has explained the Government's rationale very well to the House and the Committee, I find it unconvincing.

Sandra Gidley: I thank all those involved with the Bill, including my hon. Friend the Member for Leeds, North-West (Greg Mulholland), who led debate on various aspects of the Bill in Committee. I also thank Conservative Members and the Minister for what have been on the wholethere were a couple of notable exceptionsrelatively good-natured proceedings. A genuine attempt has been made to get to the bottom of some of the issues, and I thank the Minister for taking on board some of our concerns. I would also like to put on record my thanks to the Committee Clerks, who were unfailingly helpful and approachable. My only concern is that the selection of amendments on Report left a little bit to be desired. Some of us would have liked to discuss certain aspects of the Bill in greater depth, such as the health in pregnancy grant, but that was not to be; that pleasure has been reserved for the other place.
	Although the bulk of the Bill is involved with the setting up of the Care Quality Commission and deals with health care regulation, it is also worth mentioning in passing the bits that were also important but have not attracted as much attention. I am thinking of health care-acquired infections and the public health measures as well as the health in pregnancy grant, which I have mentioned. The Bill also includes provisions on the measurement of childhood growth and the way in which the global sum is allocated to PCTs for pharmaceutical services.
	Although the evidence sittings were useful, the Committee stage was somewhat frustrating because not a single Opposition amendment was accepted. However, I have to be fairwhen the Minister said that he would reflect on an issue, he sometimes came back with Government amendments. They did not always meet all our concerns, but they were a welcome step in the right direction. Those amendments dealt with reports to the commission, and we have seen movement on legally qualified chairs. We have been promised some movement on the issue of human rights in care homes, which concerned hon. Member on both sides of the Committee.
	I should like to conclude by talking generally about the Care Quality Commission. The Liberal Democrats supported the principle of the commission three years ago. As the Minister said earlier, we were asking the Government, Why do you not do this now? Both the Healthcare Commission and the Commission for Social Care Inspection are starting to perform well. Although I support the principle of joined-up administration and regulation, there are genuine concerns about how the transition should be handled. In the changeover, we should not lose the efficiency and effectiveness of the two organisations.
	We already know that the transition costs are likely to be 140 million. What concerns me more is the massive disruption to the two organisations and the staff involved. At this point, it is pertinent to reflect on Ian Kennedy's statement for the Public Bill Committee:
	What we will see will be a period of flux: senior staff will need to be recruited and then appoint others; managers will be organising 'away-days' and locked in meetings over organisational design and conditions of employment, instead of meeting the accelerating demands and expectations of patients. Morale in existing organisations will be increasingly hard to sustain. Good members of staff are already leaving, taking with them the knowledge that it has taken three years to develop.
	The issue is a concern to us all. The memory of the organisation of PCTs is still fresh: there was a period of stasis in many areas, while people, rightly, fretted about their jobs and reorganised. That put a halt to some parts of what the Government were trying to achieve.
	We must not make the same mistake with this reorganisation. Much has yet to be decided by secondary legislation, so there is still great uncertainty. All the people who work in the field and are likely to work for the new commission need as much certainty as possible as early in the process as possible. To deny that certainty would have a knock-on effect on patients and the public.
	It is probably worth reminding the House of Ian Kennedy's concluding remarks:
	the reasons for the Bill are unclear...the costs are high...the distraction is very considerable...the risk of harm to patients is significant. We believe that the Committee should seek to be satisfied that each of these matters has been properly taken account of and that the concerns expressed here are unwarranted.
	While the reasons for the Bill are fairly clear, as regards costs, distraction and potential harm to patients, I am not sure that I can put my hand on my heart and say that we have done full justice to those concerns in Committee. There will be continued scrutiny in the other place, and we may yet see aspects of the Bill come back. I give a cautious welcome to the Bill but seek reassurances that some of these concerns will be addressed.

Stephen Hesford: Along with other Members who are here, I served on the Public Bill Committee, and I want to put before the House one or two comments about my experience of listening to evidence at that stage, which is a relatively new procedure. It was useful in informing our proceedings, not least when we saw the Minister cross-examining people who came to give evidence and then giving evidence himself. That was a useful exercise for him to go through in the knowledge that he would be on both ends of it.
	I want to pick up four points, three of which deal with the evidence that we heard. I commend the Minister for the successful way in which he dealt with part 1, which establishes the Care Quality Commission. That is one of the reasons why I wish the Bill well from now on as it leaves this place, in contradistinction to the hon. Member for Romsey (Sandra Gidley). The Liberal Democrats welcome the change in principle and then go on to quibble about the timing of the merger and how it is going to take place, and say that the staff who are being reorganised want certainty.

Greg Mulholland: Will the hon. Gentleman give way?

Stephen Hesford: No. I am sure that the hon. Member for Romsey is big enough to intervene on me if she wants, but I am not having her boy do it.

Sandra Gidley: rose

Madam Deputy Speaker: Order. I remind hon. Members to be a little careful in matters of taste when they use expressions in the Chamber.

Sandra Gidley: I am slightly bemused by the hon. Gentleman's comments about having a boy to do my work for me, but I will not press that point. I think that he is being a little unfair. He was not here for the whole Report stage and has just come in for Third Reading, and he is not doing his own Government a service if he dismisses some of the legitimate concerns that have been raised. I am merely reflecting the concerns of people who know far more about this than he or I ever will.

Stephen Hesford: Three commissions are to be mergedthe Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Act Commission. That is a major step forward. It reduces what people in other places have called the quangocracy. It pools expertise and creates the certainty that has been mentioned. It creates what will grow into a one-stop shop, which will be a major step forwarda place to which the public will know that they can go if they have problems with social services, the NHS or mental health services. It is also consistent with the Government's rightly made efforts to bring the NHS and social care closer together; it will pool such expertise.
	Let me come to the reform of the General Medical Council in part 2. In Committee, one piece of evidence informed that process, but unfortunately it did so in a negative way. Evidence was submitted by the British Medical Association, which tried to persuade the Committee that it would not be right to change the standard of proof in disciplinary proceedings for doctors from the high standard of beyond reasonable doubt to the civil standard. The evidence that we heard from doctors frankly bordered on the self-interested. It was not helpful to the Committee, and closer examination showed that it made the case for the change.
	A positive, informative and impressive piece of evidence came from Dame Janet Smith, who spoke about the need for legally qualified chairs to help in the restoration of public confidence in the procedure for making complaints about doctors. She made a powerful case. I am pleased that my hon. Friend the Minister recognised that there was a case to be made, as we all did in Committee. I was saddened slightly by a recent article in one of the national newspapers from the GMC that seemed to be still arguing against the reform process. That is a bit of a hangover from the GMC's previous position. It has recognised that reform is necessary, but it is slightly unhelpful that it is still clinging on to former glories as that reform moves on.
	As the hon. Member for Eddisbury (Mr. O'Brien) said, the health in pregnancy grant was not mentioned on Report. I welcome that grant, and from listening to the evidence, it seemed that one could make a case for giving the grant to help a prospective mother at any stage of pregnancy. The Minister gave evidence, which I found credible and persuasive, that that stage should be located at the point set out in the Bill. Prospective mothers will know that they will benefit from the health in pregnancy grant at the 26-week stage, and by accessing the grant, they can access help and information about diet and other factors. That is a good thing and it will help less prepared mothers to look after their children. Once the grant becomes well known, mothers will know that they can get money at that time, and take it into account for their budget during the entire pregnancy. That deals with the pointand the criticismthat it could be done at some other time. In some ways, it does not matter when the money arrives as long as the prospective mother knows that it is coming. It helps to spread the load.
	The rights-based approach that the YL case raised was rightly not included in the Bill and was perceived to be part of the governance of Britain agenda, which will be tackled in due course.
	I welcome the Bill.

Brian Jenkins: I shall not detain the House. Having sat through many hours in Committee, I can honestly say that I welcome the Bill. I especially welcome the merger of the regulatory authorities, perhaps leading away from the silo mentality to a cross-area concept.
	I hope that when the Minister, who now has substantial regulatory powers, meets groups, he will realise that some are self-interested. Although they are professionals who purport to want to do their job and to need some authority and power to do it, I hope that he will bear it in mind at all times that patients are the people whom we look after. That is our current difficulty: we lack a strong patient voice. I therefore ask my hon. Friend not to be a stranger to us in the Chamber, because many of us have at least a little experience of patients' concerns from their visits to our surgeries.
	When my hon. Friend makes the regulations, will he do us a favour? Will he come back to the Chamber and get us on board? Will he tell us what he is doing, and how he is updating and altering the regulations under the Bill? He knows that much latitude has been given to the new regulatory body. Although we all wish it well, it will not do some things. It will be reticent to tackle some matters, and it may need a little pressure to deliver. If my hon. Friend can come back and convince us, perhaps we can give him the authority to exert that pressure to deliver for the right peoplethe patients. I wish him well.
	 Question put and agreed to.
	 Bill accordingly read the Third time, and passed.

DELEGATED LEGISLATION

Madam Deputy Speaker: With the leave of the House, I shall put motions 2, 3, 4 and 5 together.
	 Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Delegated Legislation Committees),

Companies

That the draft Statutory Auditors (Delegation of Functions etc) Order 2008, which was laid before this House on 17th December, be approved.
	That the draft Companies (Trading Disclosures) Regulations 2008, which were laid before this House on 17th December, be approved.

Local Government

That the draft County Durham (Structural Change) Order 2008, which was laid before this House on 8th January, be approved.
	That the draft Northumberland (Structural Change) Order 2008, which was laid before this House on 8th January, be approved. [Mr. Blizzard.]
	 Question agreed to.
	 Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) Delegated Legislation Committees),

Local Government

That the draft Cornwall (Structural Change) Order 2008, which was laid before this House on 8th January, be approved. [Mr. Blizzard.]
	 The House proceeded to a Division.

Madam Deputy Speaker: I ask the Serjeant at Arms to investigate the delay in the No Lobby.

The House having divided: Ayes 287, Noes 116.

Question accordingly agreed to.

EUROPEAN COMMUNITY DOCUMENTS

Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Committees),

Electricity and Gas Supply and Transmission Networks

That this House takes note of European Union Documents No. 13043/07, 13045/07, 13212/07, 13219/07, 13046/07, 13048/07 and 13049/07 on regulation of electricity and gas supply and transmission networks and cross-border electricity and gas networks; further notes the Government's support for the European Commission's proposals for further legislation on the internal energy market; agrees that adoption of the measures would make a major contribution to the development of competition in the sector across the EU; and supports the Government's intention to press in the negotiations for the powers of the Agency for the Cooperation of Energy Regulators to be strengthened. [Mr. Blizzard. ]
	 Question agreed to.

INSURANCE INDUSTRY (REGULATION)

Motion made, and Question proposed, That this House do now adjourn. [Mr. Blizzard.]

Denis Murphy: I thank Mr. Speaker for granting me the debate. The case that I am raising relates to an individual constituent, Mrs. Susan Hurrell, who I believe has been the victim of a major injustice at the hands of Scottish Provident. I do so with her agreement and the issue is not subject to any form of legal proceedings. I shall briefly explain the unfortunate series of events that led up to the debate.
	Mrs. Hurrell came to see me at my Friday surgery in January 2007. I was so concerned by what she told me that, in an attempt to resolve the issue, I wrote to Scottish Provident, offering to meet its representatives. Unfortunately, for reasons best known to themselves, they chose not to take up that offer. Since my initial letter of January 2007, numerous additional letters from my constituent and from me have not brought about a satisfactory and just resolution. Unfortunately, referring the case to the ombudsman also failed to bring about the desired result.
	In October 2003, Mr. and Mrs. Hurrell took out a life assurance mortgage policy. Sadly, some 14 months later, in December 2004, Mrs. Hurrell was diagnosed as being terminally ill with stage 3 category C ovarian cancer. She was told that she had only a few months to live. Once my constituent and her husband had come to terms with the shock of that, they contacted Scottish Provident by telephone to inform them of Mrs. Hurrell's medical condition and to request a claim form. Their first telephone contact with Scottish Provident was made in December 2004, and they were extremely surprised to be informed that they did not have terminal illness cover and that it would not be possible for them to make a claim except in the event of death. They were both devastated by that advice, as they were convinced that the cover was an important part of the policy. I am sure that that undoubtedly added to the worry and distress that they were already suffering.
	A few weeks later, in January 2005, Mr. Hurrell telephoned Scottish Provident to check that the information he had been given was correct. They were again advised that it was not possible for them to make a claim as they did not have terminal illness cover. It is worth noting at this juncture that the telephone calls made in both December 2004 and January 2005 were made well within the 13-week claim period allowed to submit a claim. If Scottish Provident had accepted at that stage that Mrs. Hurrell had terminal illness cover, the claim could have been submitted, considered and determined. In the words of Mrs. Hurrell:
	As Scottish Provident is a reputable company, we took this advice as correct and did not question it further.
	Mrs. Hurrell underwent emergency surgery and a heavy course of chemotherapy. Against all the medical odds, she survived and, although very ill, is alive today.
	Some 20 months after Mrs. Hurrell was diagnosed as being terminally ill, she and her husband received a letter from their mortgage company about the renewal of their mortgage protection plan. Mrs. Hurrell contacted the company, advising it that she would require a quotation without her name on the policy. Understandably, she was asked why she did not want her name to be on it. When she explained her circumstances, the staff member at the mortgage company was surprised and, having checked the policy, advised her that she was indeed covered for terminal illness and should contact Scottish Provident immediately.
	On 19 September 2006, Mrs. Hurrell rang Scottish Provident about the advice given in December 2004 and January 2005. The lady to whom she spoke was extremely apologetic about the advice, and said that she would send a claim form without delay. She then asked Mrs. Hurrell when she had been diagnosed. Having given the date of the diagnosis, Mrs. Hurrell was told, Sorry, you are too late. You had to die within the first 12 months. Apart from anything else, that was a terribly callous statement. However on 23 September 2006, Mrs. Hurrell received a letter from Scottish Provident apologising for the incorrect advice and confirming that terminal illness cover was included in death benefit. Enclosed in the letter was a claim form and a request that it be returned along with the original policy document. If the claim could then proceed, Scottish Provident would contact the relevant doctors.
	After numerous letters from Scottish Provident indicating that it was awaiting a response from Mrs. Hurrell's consultant, a further letter arrived on 5 January 2007 notifying Mrs. Hurrell of the failed outcome of her terminal illness claim. It stated:
	Our definition of terminal illness against which your claim was assessed requires that life expectancy is no greater than twelve months.
	It is also worth noting that Mr. Naik, a consultant gynaecologist and oncologist based at Queen Elizabeth hospital in Gateshead, had written to Scottish Provident on 27 November 2006 stating:
	I can confirm that when Mrs. Hurrell originally presented to us with her diagnosis of ovarian cancer she was in a desperate condition requiring emergency surgery, following which she had a number of severe complications. Her life expectancy at that time was certainly less than twelve months.
	To me it is abundantly clear that when she made the initial contact with Scottish Provident in December 2004 and January 2005, Susan's condition was such that she met the requirements of the policy: that is, life expectancy was no greater than 12 months. Consequently, in my opinion she should have been paid in full.
	Susan wrote complaining about the decision, and received a response on 23 January 2007 telling her that she had not informed the company within the required 13-week period, and that the medical information did not support her claim. Given that Scottish Provident had written to her four months earlier apologising for the fact that she had been given incorrect advice about terminal illness cover, it seems strange that it should now say that she had not informed it within 13 weeks. In fact, she had informed it twice. The letter from Mr. Naik, her consultant, was devastatingly clear: she would not survive for 12 months. How can the company possibly claim that there is no medical evidence to support the claim?
	The chief medical officer for Scottish Provident said that, in any event, the company would have waited to discover the outcome of the surgery and chemotherapy before deciding whether to meet the claim. Surely the main reason for taking out terminal illness cover is to enable people to put their finances in order before they die, and payment should consequently be made as soon as the prognosis of life expectancy of less than 12 months has been delivered. If it was normal practice to defer an assessment of terminal illness until after the response to chemotherapy was known, the company was in effect waiting for a person to die within the 12 months before paying out. Why on earth then are people paying the extra for terminal illness cover? If the company is delaying claims of that nature by more than 12 months, it is doing so deliberately to deny customers their rightful payments. It would be interesting to know how often Scottish Provident has applied that practice, and how many claimants have been denied terminal illness payments as a result. It is worth noting also that the basis of Mrs. Hurrell's claim was the medical assessment of Mr. Naik, who is an eminent consultant. The basis of Scottish Provident's case is not what it did, but what it said it might have done at the time; it is based purely on hindsight. If the claim had been accepted, Mr. and Mrs. Hurrell would have been entitled to receive a lump sum benefit of 60,000. Instead, she was offered 150 for her distress and inconvenience.
	Subsequently, Mrs. Hurrell sought the assistance of the financial services ombudsman. Unfortunately, that was without success, as the adjudicator concluded that she could not recommend that the complaint be upheld. As part of her findings, the adjudicator stated:
	I believe that it would have been reasonable for Scottish Mutual to await your response to treatment at the time.
	I am both bitterly disappointed and amazed at that finding. In my view, to defer an assessment of terminal illness until after treatment is contrary to Scottish Provident's own stipulation, which states that someone must be suffering from a terminal illness with a life expectancy of less than 12 months as diagnosed by the attending consultant. It is my view that Scottish Provident, backed by the ombudsman, is deliberately breaking the rule and spirit of its own policy, as nowhere does it state it must wait and see.
	The UK insurance industry is the largest in Europe and the third largest in the world. I am not suggesting that this case in any way reflects on an industry that rightly prides itself on the quality of its products. I hope that this case is a rarity and no one else has had to suffer what Mrs. Hurrell has gone through.
	Scottish Provident is the brand name of Scottish Mutual Assurance Ltd. On its website it describes itself as one the leading providers of life, terminal illness, income protection and unemployment cover. It states that it has a track record that can be trusted, concluding with the statement that since 1996 it has consistently paid out on claims. This certainly is not the case for Mrs. Hurrell. Frankly, the company has behaved disgracefully by first misinforming Mr. and Mrs. Hurrell that they were not coveredit did that not once, but twiceand then refusing to pay what was an entirely legitimate claim and offering an insulting 150 for her distress and inconvenience, instead of paying out the 60,000 she was entitled to.
	Mrs. Hurrell's situation is not good. The disease returned some months ago and she has been very ill. This has been an extremely traumatic period for Mrs. Hurrell and I cannot help but believe that the anxiety, distress and pressure that she has had to deal with as a result of the dispute with Scottish Provident will have had a detrimental effect on her health. When Mr. and Mrs. Hurrell took out the terminal illness cover, they will have hoped that it was a claim they would never have to make. Sadly, that proved not to be the case. It appears as if Scottish Provident has been determined to prevent this claim from being successful. However, even at this 11th hour I hope that Scottish Provident will take positive action to resolve this claim in favour of Mrs. Hurrell. I also request that my hon. Friend examines the regulations pertaining to insurance companies with a view to ensuring that there is greater clarity and protection for customers and preventing insurance companies from taking advantage of the often ambiguous wording of their policies. Mr. and Mrs. Hurrell did everything responsibly, including ensuring that they had adequate insurance cover. I ask my hon. Friend the Minister to join me in calling on Scottish Provident to pay Mr. and Mrs. Hurrell, even at this late date, the full amount of the policy that they are entitled to.

Angela Eagle: I congratulate my hon. Friend the Member for Wansbeck (Mr. Murphy) on securing this debate on an extremely important and particular casehe outlined it in great detailthat also gives rise to general issues regarding the way that insurance is regulated.
	I want to start by saying how sorry I am to hear of Mrs. Hurrell's illness, which on its own must have made the past few years incredibly difficult. I am sure that the frustrations, which my hon. Friend has outlined, with her insurance policy and with the Financial Ombudsman Service have only added to her distress. I certainly hope that the company has been listening extremely carefully to my hon. Friend tonight.
	What happened to Mrs. Hurrell demonstrates that although insurance is a hugely important product that can provide customers with peace of mind as well as financial protection, it can also be complex. It is important that all customers know what they are buying, and that they are appropriately informed by the professional services that the insurance industry brings to bear on products that it has sold. This is one reason why the Government replaced the confusing collection of financial service regulators, complaint adjudicators and compensation schemes that we inherited in 1997 with the Financial Services Authority, the financial services compensation scheme and the Financial Ombudsman Service.
	The FSA is now responsible for the regulation of the insurance industry and has laid down detailed rules on all aspects of the conduct of business of regulated firms. In a constantly evolving market, however, as my hon. Friend demonstrated, rules-based regulation can often lag behind new products or circumstances. That is why the FSA is moving toward more principle-based regulation, instead of specifying detailed processes to be performed. This means being clear about the required regulatory outcomes, and then using supervision and enforcement to ensure that they are achieved. The new, simplified conduct-of-business rules that the FSA published in November, and for the insurance sector specifically in January, take this approach. That does not mean that the rules have been relaxed, however. The FSA also took the opportunity to require firms to take reasonable steps to establish that customers would be eligible to make a claim under a particular policy, and to ensure better standards of disclosure, so that consumers can make more informed decisions.
	This approach is also reinforced by the general principle that firms must treat customers fairly. Obviously, firms should be doing that already, and I will leave it for others to judge what has happened in this instance, but by the end of the year, firms will have to be able to demonstrate to themselves and to the FSA that they are consistently treating their customers fairly. In particular, they will need to demonstrate that customers are provided with clear information and kept appropriately informed before, during and after the point of sale, and that any advice is suitable and takes account of their circumstances. Again, whether this has been achieved in this very difficult instance is for other people to judge.
	On Mrs. Hurrell's specific case, let me say again that I am sorry to hear of the difficulties that she has had with her health and, as a consequence, with the insurance policies that she took out and with the Financial Ombudsman Service, on top of her illness. I think it best, given the information that my hon. Friend has put before the House tonight, if I invite him to write to me with more details and specific dates. I will certainly refer this case to Hector Sants, the FSA's chief executive, asking him to get in touch with my hon. Friend to explain the impact of such regulations. I also want to write to the Association of British Insurers' director-general, drawing attention to this case and asking him to take Mrs. Hurrell's experience into account when the industry reviews, in the 12-month period to 2009, the definition of terminal illness that is used across the whole insurance industry, to see whether changes can be made that might make the definition more understandable for everybody concerned.
	I also wish to contact the Financial Ombudsman Service again, given some of the details that my hon. Friend has put before the House tonight, so that it can check whether it has got everything right in its adjudications so far. If my hon. Friend will write to me soon, I will ensure that I get the letters sent to the appropriate people to see if there is any way forward in this case.
	I also hope that the insurer has listened to what my hon. Friend has to say. If it wished, it could take the matter forward to a satisfactory conclusion, although that is of course a matter for it and not for me. However, I can assure my hon. Friend that I will make inquiries to see whether anything else can be done in these very particular circumstances to make any progress in Mrs. Hurrell's unfortunate situation.
	 Question put and agreed to.
	 Adjourned a ccordingly at five minutes to  Ten o'clock.